- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $1,071.52 / $6,456.54
| Facility | | $46.77 | $1,071.52 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $79.43 / $2,344.23 / $3,630.78
| Facility | 50 | $79.43 | $2,344.23 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $44.67 / $69.18
| Professional | | $30.90 | $44.67 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $57.54 / $64.57 / $67.61
| Professional | 50 | $57.54 | $64.57 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $44.67 / $58.88
| Professional | | $34.67 | $44.67 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $43.65 / $67.61 / $79.43
| Professional | 50 | $43.65 | $67.61 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $154.88 / $218.78
| Facility | | $109.65 | $154.88 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $44.67 / $61.66
| Professional | | $32.36 | $44.67 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $54.95 / $79.43
| Professional | | $35.48 | $54.95 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $79.43 / $1,659.59
| Facility | | $33.88 | $79.43 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $117.49 / $117.49 / $117.49
| Facility | 52 | $117.49 | $117.49 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $56.23 / $354.81
| Professional | | $41.69 | $56.23 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $549.54 / $1,548.82
| Facility | | $89.13 | $549.54 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $42.66 / $63.10
| Professional | | $30.20 | $42.66 | $63.10 |