- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $7,585.78 / $19,054.61
| Facility | | $194.98 | $7,585.78 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $263.03 / $316.23 / $912.01
| Facility | 50 | $263.03 | $316.23 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $43.65 / $109.65
| Professional | | $19.95 | $43.65 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $28.18 / $60.26 / $245.47
| Professional | 50 | $28.18 | $60.26 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $15.85 / $40.74
| Professional | | $13.80 | $15.85 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $4,466.84 / $12,882.50
| Facility | | $2,511.89 | $4,466.84 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $77.62 / $141.25
| Professional | | $40.74 | $77.62 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $27.54 / $37.15 / $107.15
| Professional | 50 | $27.54 | $37.15 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $3,162.28 / $6,606.93
| Facility | | $85.11 | $3,162.28 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $70.79 / $144.54
| Professional | | $50.12 | $70.79 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $54.95 / $102.33
| Professional | | $26.92 | $54.95 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $29.51 / $51.29
| Professional | | $22.91 | $29.51 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $22.91 / $45.71
| Professional | | $18.20 | $22.91 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $1,288.25
| Facility | | $54.95 | $56.23 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $407.38 / $660.69
| Professional | | $407.38 | $407.38 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $28.84 / $47.86
| Professional | | $28.84 | $28.84 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $38.02 / $95.50
| Facility | | $21.88 | $38.02 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $54.95 / $107.15
| Professional | | $28.18 | $54.95 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $87.10 / $93.33
| Professional | | $87.10 | $87.10 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $51.29 / $79.43
| Professional | | $19.95 | $51.29 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $1,548.82 / $6,456.54
| Facility | | $446.68 | $1,548.82 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $41.69 / $75.86
| Professional | | $20.89 | $41.69 | $75.86 |