- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $1,148.15 / $5,888.44
| Facility | | $70.79 | $1,148.15 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $58.88 / $288.40 / $2,951.21
| Facility | 50 | $58.88 | $288.40 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $112.20 / $112.20 / $112.20
| Facility | 52 | $112.20 | $112.20 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $51.29 / $134.90
| Professional | | $30.20 | $51.29 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $47.86 / $100.00 / $281.84
| Professional | 50 | $47.86 | $100.00 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $30.20 / $34.67 / $151.36
| Professional | 52 | $30.20 | $34.67 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $45.71 / $57.54
| Professional | | $36.31 | $45.71 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $53.70 / $69.18 / $83.18
| Professional | 50 | $53.70 | $69.18 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $87.10 / $194.98
| Facility | | $44.67 | $87.10 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $39.81 / $64.57
| Professional | | $26.30 | $39.81 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $83.18 / $616.60
| Facility | | $58.88 | $83.18 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $51.29 / $74.13
| Professional | | $33.11 | $51.29 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $45.71 / $45.71
| Facility | | $26.92 | $45.71 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $54.95 / $97.72
| Professional | | $35.48 | $54.95 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $2,951.21
| Facility | | $54.95 | $56.23 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $162.18 / $162.18 / $162.18
| Facility | 52 | $162.18 | $162.18 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $346.74 / $398.11
| Professional | | $63.10 | $346.74 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $70.79 / $3,311.31
| Facility | | $34.67 | $70.79 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $53.70 / $173.78 / $2,884.03
| Facility | 50 | $53.70 | $173.78 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $112.20 / $112.20 / $112.20
| Facility | 52 | $112.20 | $112.20 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $48.98 / $93.33
| Professional | | $30.20 | $48.98 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $44.67 / $97.72 / $269.15
| Professional | 50 | $44.67 | $97.72 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $30.20 / $34.67 / $151.36
| Professional | 52 | $30.20 | $34.67 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $32.36 / $38.02
| Professional | | $25.70 | $32.36 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $104.71 / $123.03
| Professional | | $3.98 | $104.71 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $50.12 / $93.33
| Facility | | $30.20 | $50.12 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $56.23 / $97.72
| Professional | | $35.48 | $56.23 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $831.76 / $2,290.87
| Facility | | $95.50 | $831.76 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $44.67 / $74.13
| Professional | | $29.51 | $44.67 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $112.20
| Professional | 50 | $79.43 | $79.43 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $48.98 / $48.98
| Professional | | $45.71 | $48.98 | $48.98 |