- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $8,709.64 / $22,387.21
| Facility | | $2,818.38 | $8,709.64 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,630.78 / $6,165.95 / $18,620.87
| Facility | 50 | $3,630.78 | $6,165.95 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $602.56 / $2,089.30
| Professional | | $380.19 | $602.56 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $77.62 / $588.84 / $3,019.95
| Professional | 50 | $77.62 | $588.84 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $10,471.29 / $17,782.79
| Facility | | $6,025.60 | $10,471.29 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $691.83 / $1,513.56
| Professional | | $457.09 | $691.83 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $575.44 / $758.58 / $1,445.44
| Professional | 50 | $575.44 | $758.58 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $6,165.95 / $12,589.25
| Facility | | $85.11 | $6,165.95 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $630.96 / $1,513.56
| Professional | | $436.52 | $630.96 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $1,445.44 / $1,995.26
| Facility | | $707.95 | $1,445.44 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $588.84 / $1,148.15
| Professional | | $426.58 | $588.84 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $616.60 / $954.99
| Professional | | $436.52 | $616.60 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $575.44 / $1,096.48
| Professional | | $389.05 | $575.44 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $33,884.42 / $33,884.42
| Facility | | $6,165.95 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,623.41 / $5,623.41 / $5,623.41
| Professional | | $5,623.41 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $446.68 / $758.58
| Professional | | $446.68 | $446.68 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $676.08 / $1,023.29
| Facility | | $467.74 | $676.08 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $602.56 / $1,174.90
| Professional | | $426.58 | $602.56 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,412.54 / $1,698.24
| Professional | | $1,412.54 | $1,412.54 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $602.56 / $812.83
| Professional | | $407.38 | $602.56 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $7,079.46 / $15,135.61
| Facility | | $3,630.78 | $7,079.46 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $478.63 / $1,071.52
| Professional | | $354.81 | $478.63 | $1,071.52 |