- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $954.99 / $1,698.24 / $18,620.87
| Facility | | $954.99 | $1,698.24 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,309.57 / $6,760.83 / $11,220.18
| Facility | 50 | $6,309.57 | $6,760.83 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $741.31 / $2,187.76
| Professional | | $489.78 | $741.31 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $407.38 / $1,148.15 / $4,677.35
| Professional | 50 | $407.38 | $1,148.15 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $6,165.95 / $12,589.25
| Facility | | $4,466.84 | $6,165.95 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,606.93 / $9,332.54 / $19,054.61
| Facility | 50 | $6,606.93 | $9,332.54 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,230.27 / $1,698.24
| Professional | | $891.25 | $1,230.27 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $912.01 / $2,454.71
| Facility | | $912.01 | $912.01 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,000.00 / $1,862.09
| Professional | | $588.84 | $1,000.00 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,174.90 / $2,041.74
| Facility | | $645.65 | $1,174.90 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $5,754.40 / $9,332.54 / $16,595.87
| Facility | 50 | $5,754.40 | $9,332.54 | $16,595.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,148.15 / $1,659.59
| Professional | | $645.65 | $1,148.15 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $380.19
| Professional | | $32.36 | $33.11 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,230.27 / $1,318.26
| Facility | | $776.25 | $1,230.27 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $870.96 / $891.25
| Facility | | $870.96 | $870.96 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $1,071.52 / $1,621.81
| Professional | | $691.83 | $1,071.52 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $6,456.54 / $12,589.25
| Facility | | $4,365.16 | $6,456.54 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,606.93 / $9,772.37 / $19,054.61
| Facility | 50 | $6,606.93 | $9,772.37 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,258.93 / $1,698.24
| Professional | | $891.25 | $1,258.93 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $6,918.31 / $13,182.57
| Facility | | $1,288.25 | $6,918.31 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $870.96 / $1,584.89
| Professional | | $630.96 | $870.96 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $776.25 / $1,445.44
| Professional | | $87.10 | $776.25 | $1,445.44 |