- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $4,168.69 / $7,943.28
| Facility | | $489.78 | $4,168.69 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,621.81 / $3,890.45 / $16,218.10
| Facility | 50 | $1,621.81 | $3,890.45 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $380.19 / $851.14
| Professional | | $263.03 | $380.19 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $436.52 / $794.33 / $1,621.81
| Professional | 50 | $436.52 | $794.33 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $6,606.93 / $57,543.99
| Facility | | $6,456.54 | $6,606.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $575.44 / $676.08
| Professional | | $380.19 | $575.44 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $501.19 / $851.14 / $1,023.29
| Professional | 50 | $501.19 | $851.14 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $407.38 / $630.96
| Professional | | $275.42 | $407.38 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $616.60 / $645.65
| Professional | | $616.60 | $616.60 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $478.63 / $724.44
| Professional | | $323.59 | $478.63 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $3,801.89 / $6,606.93
| Facility | | $2,089.30 | $3,801.89 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,862.09 / $3,890.45 / $7,244.36
| Facility | 50 | $1,862.09 | $3,890.45 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $3,235.94 / $8,317.64
| Facility | | $416.87 | $3,235.94 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $5,011.87 / $5,011.87 / $8,709.64
| Facility | 50 | $5,011.87 | $5,011.87 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $398.11 / $851.14
| Professional | | $269.15 | $398.11 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $602.56 / $831.76
| Professional | | $371.54 | $602.56 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $436.52 / $933.25
| Facility | | $281.84 | $436.52 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $380.19 / $933.25
| Professional | | $281.84 | $380.19 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $3,311.31 / $5,495.41
| Facility | | $1,659.59 | $3,311.31 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $371.54 / $645.65
| Professional | | $245.47 | $371.54 | $645.65 |