- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $794.33 / $17,782.79
| Facility | | $251.19 | $794.33 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,071.52 / $1,071.52 / $1,288.25
| Facility | 50 | $1,071.52 | $1,071.52 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $223.87 / $831.76
| Professional | | $131.83 | $223.87 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $100.00 / $346.74 / $1,479.11
| Professional | 50 | $100.00 | $346.74 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $776.25 / $1,584.89
| Facility | | $630.96 | $776.25 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $954.99 / $1,174.90 / $2,344.23
| Facility | 50 | $954.99 | $1,174.90 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $309.03 / $436.52
| Professional | | $218.78 | $309.03 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $380.19 / $478.63
| Facility | | $380.19 | $380.19 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $269.15 / $501.19
| Professional | | $162.18 | $269.15 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $288.40 / $446.68
| Facility | | $181.97 | $288.40 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $724.44 / $1,174.90 / $2,089.30
| Facility | 50 | $724.44 | $1,174.90 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $288.40 / $416.87
| Professional | | $181.97 | $288.40 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $104.71
| Professional | | $32.36 | $33.11 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $316.23 / $389.05
| Facility | | $263.03 | $316.23 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $213.80 / $218.78
| Facility | | $213.80 | $213.80 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $269.15 / $398.11
| Professional | | $173.78 | $269.15 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $812.83 / $1,584.89
| Facility | | $549.54 | $812.83 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $812.83 / $1,202.26 / $2,344.23
| Facility | 50 | $812.83 | $1,202.26 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $309.03 / $436.52
| Professional | | $218.78 | $309.03 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $1,000.00 / $2,137.96
| Facility | | $154.88 | $1,000.00 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $257.04 / $398.11
| Professional | | $173.78 | $257.04 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $190.55 / $354.81
| Professional | | $21.38 | $190.55 | $354.81 |