- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $2,511.89 / $7,585.78
| Facility | | $575.44 | $2,511.89 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $630.96 / $1,862.09
| Facility | | $380.19 | $630.96 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $316.23 / $331.13
| Facility | | $79.43 | $316.23 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $616.60 / $616.60
| Facility | | $616.60 | $616.60 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $380.19 / $380.19 / $380.19
| Facility | 62 | $380.19 | $380.19 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $61.66
| Facility | AS | $61.66 | $61.66 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $2,187.76
| Facility | | $54.95 | $56.23 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $1,380.38 / $1,380.38 / $1,380.38
| Facility | 62 | $1,380.38 | $1,380.38 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $218.78 / $218.78 / $218.78
| Facility | AS | $218.78 | $218.78 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $562.34 / $3,715.35
| Facility | | $346.74 | $562.34 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $478.63 / $812.83
| Facility | | $331.13 | $478.63 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $354.81 / $354.81 / $354.81
| Facility | 62 | $354.81 | $354.81 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $57.54 / $57.54 / $57.54
| Facility | AS | $57.54 | $57.54 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $954.99 / $2,398.83
| Facility | | $162.18 | $954.99 | $2,398.83 |