- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $3,090.30 / $8,912.51
| Facility | | $426.58 | $3,090.30 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $912.01 / $8,317.64
| Professional | | $199.53 | $912.01 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $6,165.95 / $7,585.78
| Facility | | $4,168.69 | $6,165.95 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $407.38 / $933.25
| Professional | | $208.93 | $407.38 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $257.04 / $257.04
| Facility | | $257.04 | $257.04 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $208.93 / $275.42
| Professional | | $190.55 | $208.93 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $630.96 / $1,000.00
| Facility | | $537.03 | $630.96 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $426.58 / $616.60
| Professional | | $229.09 | $426.58 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $616.60 / $6,918.31
| Facility | | $199.53 | $616.60 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $512.86 / $645.65
| Professional | | $371.54 | $512.86 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $912.01 / $2,818.38
| Facility | | $204.17 | $912.01 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $776.25 / $776.25 / $776.25
| Facility | 52 | $776.25 | $776.25 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $97.72 / $97.72 / $97.72
| Facility | AS | $97.72 | $97.72 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $389.05 / $870.96
| Professional | | $218.78 | $389.05 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $295.12
| Professional | | $32.36 | $33.11 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $891.25 / $2,344.23
| Facility | | $436.52 | $891.25 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $524.81 / $645.65
| Professional | | $288.40 | $524.81 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $512.86 / $724.44
| Professional | | $316.23 | $512.86 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $537.03 / $1,318.26
| Facility | | $537.03 | $537.03 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $426.58 / $426.58 / $1,071.52
| Facility | 52 | $426.58 | $426.58 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $53.70 / $53.70 / $131.83
| Facility | AS | $53.70 | $53.70 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $371.54 / $1,548.82
| Professional | | $218.78 | $371.54 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $389.05 / $389.05
| Professional | | $389.05 | $389.05 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $891.25 / $1,023.29
| Professional | | $380.19 | $891.25 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,584.89 / $2,187.76
| Facility | | $1,023.29 | $1,584.89 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $323.59 / $851.14
| Professional | | $199.53 | $323.59 | $851.14 |