- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $2,187.76 / $7,079.46
| Facility | | $549.54 | $2,187.76 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $588.84 / $2,344.23
| Professional | | $239.88 | $588.84 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $23.99 / $89.13 / $346.74
| Professional | AS | $23.99 | $89.13 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $251.19 / $316.23
| Professional | | $245.47 | $251.19 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $32.36 / $34.67 / $40.74
| Professional | AS | $32.36 | $34.67 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $3,630.78 / $6,760.83
| Facility | | $831.76 | $3,630.78 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $323.59 / $630.96
| Professional | | $288.40 | $323.59 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $331.13 / $501.19
| Professional | | $234.42 | $331.13 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $389.05 / $2,041.74
| Facility | | $239.88 | $389.05 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $389.05 / $389.05 / $724.44
| Facility | 62 | $389.05 | $389.05 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $117.49
| Facility | AS | $61.66 | $61.66 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $323.59 / $1,819.70
| Professional | | $234.42 | $323.59 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,122.02 / $2,187.76
| Facility | | $660.69 | $1,122.02 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $281.84 / $478.63
| Professional | | $218.78 | $281.84 | $478.63 |