- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $213.80 / $3,235.94
| Facility | | $46.77 | $213.80 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $72.44 / $316.23 / $1,659.59
| Facility | 50 | $72.44 | $316.23 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $389.05 / $389.05 / $389.05
| Facility | 52 | $389.05 | $389.05 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $58.88 / $134.90
| Professional | | $30.20 | $58.88 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- 22
- Typical Low / Median / Typical High
- $162.18 / $162.18 / $162.18
| Professional | 22 | $162.18 | $162.18 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $50.12 / $97.72 / $295.12
| Professional | 50 | $50.12 | $97.72 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $30.20 / $43.65 / $67.61
| Professional | 52 | $30.20 | $43.65 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $45.71 / $63.10
| Professional | | $23.99 | $45.71 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $57.54 / $66.07 / $102.33
| Professional | 50 | $57.54 | $66.07 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $102.33 / $691.83
| Facility | | $75.86 | $102.33 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $54.95 / $91.20
| Professional | | $38.02 | $54.95 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $56.23 / $107.15
| Professional | | $34.67 | $56.23 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $74.13 / $169.82
| Professional | | $43.65 | $74.13 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $40.74 / $64.57
| Professional | | $38.02 | $40.74 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $645.65 / $2,089.30
| Facility | | $50.12 | $645.65 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $53.70 / $91.20
| Professional | | $35.48 | $53.70 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $85.11
| Professional | 50 | $79.43 | $79.43 | $85.11 |