- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $1,862.09 / $6,025.60
| Facility | | $0.95 | $1,862.09 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $12,589.25 / $16,218.10
| Facility | | $6,456.54 | $12,589.25 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $891.25 / $1,202.26
| Facility | | $831.76 | $891.25 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $1,995.26 / $3,235.94
| Facility | | $1,737.80 | $1,995.26 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $1,548.82 / $10,471.29
| Facility | | $676.08 | $1,548.82 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $1,698.24 / $14,125.38
| Facility | | $676.08 | $1,698.24 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $10,715.19 / $17,378.01
| Facility | | $1,412.54 | $10,715.19 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,548.82 / $2,290.87
| Professional | | $851.14 | $1,548.82 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $11,220.18 / $11,220.18
| Facility | | $1,737.80 | $11,220.18 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $1,071.52 / $1,071.52 / $7,079.46
| Facility | 62 | $1,071.52 | $1,071.52 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $173.78 / $173.78 / $1,122.02
| Facility | AS | $173.78 | $173.78 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,187.76 / $2,187.76
| Professional | | $2,187.76 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $13,803.84 / $16,595.87
| Facility | | $8,912.51 | $13,803.84 | $16,595.87 |