- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $6,606.93 / $13,489.63
| Facility | | $218.78 | $6,606.93 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $954.99 / $6,309.57 / $10,000.00
| Facility | 50 | $954.99 | $6,309.57 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $208.93 / $912.01
| Professional | | $102.33 | $208.93 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $194.98 / $501.19 / $2,137.96
| Professional | 50 | $194.98 | $501.19 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $281.84 / $281.84
| Professional | | $281.84 | $281.84 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $239.88 / $389.05 / $416.87
| Professional | 50 | $239.88 | $389.05 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $4,073.80 / $8,317.64
| Facility | | $3,090.30 | $4,073.80 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $4,677.35 / $6,025.60 / $12,302.69
| Facility | 50 | $4,677.35 | $6,025.60 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $309.03 / $407.38
| Professional | | $218.78 | $309.03 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $933.25 / $1,548.82
| Facility | | $933.25 | $933.25 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $338.84 / $489.78
| Professional | | $199.53 | $338.84 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $389.05 / $4,168.69
| Facility | | $223.87 | $389.05 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,801.89 / $5,248.07 / $10,964.78
| Facility | 50 | $3,801.89 | $5,248.07 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $354.81 / $1,202.26
| Professional | | $208.93 | $354.81 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $64.57
| Professional | | $32.36 | $33.11 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $309.03 / $323.59
| Facility | | $186.21 | $309.03 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $213.80 / $218.78
| Facility | | $213.80 | $213.80 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $338.84 / $467.74
| Professional | | $218.78 | $338.84 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $4,265.80 / $8,317.64
| Facility | | $2,884.03 | $4,265.80 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $4,265.80 / $6,309.57 / $12,302.69
| Facility | 50 | $4,265.80 | $6,309.57 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $309.03 / $436.52
| Professional | | $218.78 | $309.03 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $4,897.79 / $8,912.51
| Facility | | $1,445.44 | $4,897.79 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $239.88 / $426.58
| Professional | | $165.96 | $239.88 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $85.11
| Professional | 50 | $79.43 | $79.43 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $199.53 / $309.03
| Professional | | $162.18 | $199.53 | $309.03 |