- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $4,897.79 / $13,182.57
| Facility | | $302.00 | $4,897.79 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,715.35 / $3,715.35 / $6,025.60
| Facility | 50 | $3,715.35 | $3,715.35 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $165.96 / $457.09
| Professional | | $131.83 | $165.96 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $323.59 / $407.38
| Professional | | $162.18 | $323.59 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $295.12 / $389.05
| Professional | | $229.09 | $295.12 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $269.15 / $478.63
| Facility | | $190.55 | $269.15 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,715.35 / $3,715.35 / $6,025.60
| Facility | 50 | $3,715.35 | $3,715.35 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $263.03 / $407.38
| Professional | | $208.93 | $263.03 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $281.84 / $302.00
| Facility | | $169.82 | $281.84 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $229.09 / $389.05
| Facility | | $165.96 | $229.09 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $288.40 / $416.87
| Professional | | $79.43 | $288.40 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,413.10 / $10,232.93 / $12,302.69
| Facility | | $7,413.10 | $10,232.93 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $10,964.78 / $15,135.61 / $18,197.01
| Facility | 50 | $10,964.78 | $15,135.61 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $363.08 / $457.09
| Professional | | $281.84 | $363.08 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $6,918.31 / $14,454.40
| Facility | | $2,454.71 | $6,918.31 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $281.84 / $407.38
| Professional | | $186.21 | $281.84 | $407.38 |