- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $208.93 / $18,620.87
| Facility | | $151.36 | $208.93 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $120.23 / $239.88
| Professional | | $81.28 | $120.23 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $11.48 / $660.69 / $870.96
| Professional | 50 | $11.48 | $660.69 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $776.25 / $1,071.52 / $2,137.96
| Facility | | $776.25 | $1,071.52 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $323.59 / $323.59 / $323.59
| Facility | 50 | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $186.21 / $257.04
| Professional | | $131.83 | $186.21 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $158.49 / $281.84
| Professional | | $93.33 | $158.49 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $173.78 / $295.12
| Facility | | $112.20 | $173.78 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,023.29 / $1,698.24 / $2,951.21
| Facility | 50 | $1,023.29 | $1,698.24 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $173.78 / $251.19
| Professional | | $120.23 | $173.78 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $64.57
| Professional | | $32.36 | $33.11 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $186.21 / $199.53
| Facility | | $141.25 | $186.21 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $128.82 / $131.83
| Facility | | $128.82 | $128.82 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $165.96 / $239.88
| Professional | | $109.65 | $165.96 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,096.48 / $2,137.96
| Facility | | $724.44 | $1,096.48 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $257.04 / $257.04 / $323.59
| Facility | 50 | $257.04 | $257.04 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $186.21 / $257.04
| Professional | | $131.83 | $186.21 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $1,380.38 / $3,019.95
| Facility | | $141.25 | $1,380.38 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $141.25 / $234.42
| Professional | | $102.33 | $141.25 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $112.20 / $208.93
| Professional | | $12.88 | $112.20 | $208.93 |