- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $3,162.28 / $8,511.38
| Facility | | $22.91 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $32.36 / $114.82
| Professional | | $18.20 | $32.36 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $23.44 / $26.92 / $181.97
| Professional | 50 | $23.44 | $26.92 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $4,570.88 / $8,912.51
| Facility | | $2,238.72 | $4,570.88 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $58.88 / $91.20
| Professional | | $35.48 | $58.88 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $52.48 / $89.13 / $134.90
| Professional | 50 | $52.48 | $89.13 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $20.42 / $67.61
| Professional | | $19.05 | $20.42 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $34.67 / $95.50
| Professional | | $18.20 | $34.67 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $57.54 / $1,258.93
| Facility | | $21.38 | $57.54 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $52.48 / $645.65
| Professional | | $25.12 | $52.48 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $537.03 / $1,513.56
| Facility | | $107.15 | $537.03 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $37.15 / $67.61
| Professional | | $24.55 | $37.15 | $67.61 |