- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $3,388.44 / $5,495.41
| Facility | | $1,380.38 | $3,388.44 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $831.76 / $1,380.38
| Professional | | $478.63 | $831.76 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $707.95 / $1,995.26 / $2,089.30
| Professional | 50 | $707.95 | $1,995.26 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,715.35 / $6,025.60
| Facility | | $1,819.70 | $3,715.35 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,754.23 / $5,370.32 / $9,120.11
| Facility | 50 | $2,754.23 | $5,370.32 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,122.02 / $1,445.44
| Professional | | $891.25 | $1,122.02 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,318.26 / $1,548.82 / $2,137.96
| Professional | 50 | $1,318.26 | $1,548.82 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $851.14 / $1,258.93
| Professional | | $562.34 | $851.14 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $1,148.15 / $1,905.46
| Facility | | $478.63 | $1,148.15 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $954.99 / $1,479.11
| Professional | | $602.56 | $954.99 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $707.95 / $1,995.26 / $2,089.30
| Professional | 50 | $707.95 | $1,995.26 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $5,248.07 / $7,413.10
| Facility | | $3,981.07 | $5,248.07 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,025.60 / $8,317.64 / $10,964.78
| Facility | 50 | $6,025.60 | $8,317.64 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,122.02 / $1,548.82
| Professional | | $977.24 | $1,122.02 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $977.24 / $4,570.88
| Professional | | $660.69 | $977.24 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $12,302.69 / $12,302.69
| Facility | | $1,148.15 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $851.14 / $1,348.96
| Professional | | $575.44 | $851.14 | $1,348.96 |