- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $4,677.35 / $18,620.87
| Facility | | $870.96 | $4,677.35 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,606.93 / $6,606.93 / $6,760.83
| Facility | 50 | $6,606.93 | $6,606.93 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $676.08 / $1,412.54
| Professional | | $426.58 | $676.08 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $134.90 / $208.93 / $707.95
| Professional | 50 | $134.90 | $208.93 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $6,165.95 / $12,589.25
| Facility | | $4,365.16 | $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
- $812.83 / $1,148.15 / $1,584.89
| Professional | | $812.83 | $1,148.15 | $1,584.89 |
- 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
- $537.03 / $933.25 / $1,778.28
| Professional | | $537.03 | $933.25 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $1,122.02 / $2,041.74
| Facility | | $602.56 | $1,122.02 | $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
- $602.56 / $1,096.48 / $1,621.81
| Professional | | $602.56 | $1,096.48 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $363.08
| Professional | | $32.36 | $33.11 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $1,174.90 / $1,258.93
| Facility | | $707.95 | $1,174.90 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $831.76 / $851.14
| Facility | | $831.76 | $831.76 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $1,023.29 / $1,548.82
| Professional | | $616.60 | $1,023.29 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,265.80 / $6,456.54 / $12,589.25
| Facility | | $4,265.80 | $6,456.54 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,456.54 / $9,772.37 / $19,054.61
| Facility | 50 | $6,456.54 | $9,772.37 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,174.90 / $1,584.89
| Professional | | $851.14 | $1,174.90 | $1,584.89 |
- 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
- $575.44 / $794.33 / $1,479.11
| Professional | | $575.44 | $794.33 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $741.31 / $1,380.38
| Professional | | $83.18 | $741.31 | $1,380.38 |