- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $2,454.71 / $4,897.79
| Facility | | $977.24 | $2,454.71 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $870.96 / $2,691.53 / $4,168.69
| Facility | 50 | $870.96 | $2,691.53 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $2,570.40 / $4,466.84
| Professional | | $154.88 | $2,570.40 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $263.03 / $933.25 / $4,073.80
| Professional | 50 | $263.03 | $933.25 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $323.59 / $1,412.54
| Facility | | $158.49 | $323.59 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $371.54 / $467.74
| Professional | | $354.81 | $371.54 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $295.12 / $436.52
| Facility | | $190.55 | $295.12 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,905.46 / $2,951.21 / $8,128.31
| Facility | 50 | $1,905.46 | $2,951.21 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $281.84 / $1,445.44
| Professional | | $151.36 | $281.84 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $354.81 / $363.08
| Professional | | $323.59 | $354.81 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $323.59 / $323.59
| Professional | | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $275.42 / $316.23
| Professional | | $186.21 | $275.42 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $1,995.26 / $3,162.28
| Facility | | $1,995.26 | $1,995.26 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $316.23 / $436.52
| Professional | | $162.18 | $316.23 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $363.08 / $371.54
| Professional | | $309.03 | $363.08 | $371.54 |