- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $3,548.13 / $9,120.11
| Facility | | $912.01 | $3,548.13 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,548.82 / $1,548.82 / $1,548.82
| Facility | 50 | $1,548.82 | $1,548.82 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $776.25 / $1,819.70
| Professional | | $588.84 | $776.25 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $933.25 / $933.25 / $933.25
| Professional | 50 | $933.25 | $933.25 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $4,786.30 / $9,549.93
| Facility | | $2,630.27 | $4,786.30 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $812.83 / $1,949.84
| Professional | | $630.96 | $812.83 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $954.99 / $1,202.26 / $2,884.03
| Professional | 50 | $954.99 | $1,202.26 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,995.26 / $8,912.51
| Facility | | $912.01 | $1,995.26 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $912.01 / $1,096.48
| Professional | | $912.01 | $912.01 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $2,290.87 / $53,703.18
| Facility | | $1,071.52 | $2,290.87 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $977.24 / $2,454.71
| Professional | | $537.03 | $977.24 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $691.83 / $2,089.30
| Facility | | $549.54 | $691.83 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,096.48 / $1,621.81
| Professional | | $794.33 | $1,096.48 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $912.01 / $1,621.81
| Professional | | $537.03 | $912.01 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $794.33 / $794.33
| Professional | | $794.33 | $794.33 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $50,118.72 / $75,857.76
| Facility | | $588.84 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $954.99 / $1,584.89
| Professional | | $398.11 | $954.99 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,981.07 / $8,709.64
| Facility | | $2,137.96 | $3,981.07 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $812.83 / $1,995.26
| Professional | | $537.03 | $812.83 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $891.25 / $1,698.24
| Facility | | $524.81 | $891.25 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $891.25 / $2,630.27
| Professional | | $537.03 | $891.25 | $2,630.27 |