- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $1,445.44 / $2,570.40
| Facility | | $91.20 | $1,445.44 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $354.81 / $489.78
| Professional | | $91.20 | $354.81 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,090.30 / $5,754.40
| Facility | | $1,584.89 | $3,090.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $512.86 / $1,584.89
| Professional | | $173.78 | $512.86 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,348.96 / $2,187.76
| Facility | | $1,174.90 | $1,348.96 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $316.23 / $1,288.25
| Professional | | $177.83 | $316.23 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $2,398.83 / $4,265.80
| Facility | | $107.15 | $2,398.83 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $371.54 / $1,258.93
| Professional | | $229.09 | $371.54 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $1,949.84 / $4,168.69
| Facility | | $117.49 | $1,949.84 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $851.14 / $1,905.46
| Professional | | $467.74 | $851.14 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,019.95 / $3,235.94
| Facility | | $1,819.70 | $3,019.95 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $616.60 / $1,380.38
| Professional | | $154.88 | $616.60 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $512.86 / $1,348.96
| Professional | | $151.36 | $512.86 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,445.44 / $2,137.96
| Facility | | $1,445.44 | $1,445.44 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $1,174.90 / $1,174.90 / $1,698.24
| Facility | 52 | $1,174.90 | $1,174.90 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $912.01 / $3,019.95
| Professional | | $204.17 | $912.01 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $181.97 / $758.58
| Professional | | $181.97 | $181.97 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $794.33 / $1,949.84
| Professional | | $398.11 | $794.33 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,754.23 / $5,011.87
| Facility | | $2,041.74 | $2,754.23 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $467.74 / $1,621.81
| Professional | | $134.90 | $467.74 | $1,621.81 |