- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $3,090.30 / $8,128.31
| Facility | | $104.71 | $3,090.30 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $0.24 / $0.52 / $8,912.51
| Facility | 50 | $0.24 | $0.52 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $147.91 / $295.12
| Professional | | $75.86 | $147.91 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $79.43
| Professional | | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $4,168.69 / $12,302.69
| Facility | | $489.78 | $4,168.69 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $147.91 / $186.21
| Professional | | $83.18 | $147.91 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $489.78 / $549.54
| Facility | | $158.49 | $489.78 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $151.36 / $323.59
| Professional | | $79.43 | $151.36 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $4,466.84 / $9,120.11
| Facility | | $2,570.40 | $4,466.84 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $131.83 / $223.87
| Professional | | $75.86 | $131.83 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $204.17
| Professional | | $32.36 | $33.11 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $3,162.28 / $6,918.31
| Facility | | $776.25 | $3,162.28 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $134.90 / $251.19
| Professional | | $75.86 | $134.90 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $138.04 / $186.21
| Professional | | $72.44 | $138.04 | $186.21 |