- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $1,778.28 / $8,511.38
| Facility | | $269.15 | $1,778.28 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $436.52 / $1,258.93
| Professional | | $239.88 | $436.52 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $32.36 / $61.66 / $173.78
| Professional | AS | $32.36 | $61.66 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $302.00 / $354.81
| Professional | | $213.80 | $302.00 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $26.30 / $41.69 / $53.70
| Professional | AS | $26.30 | $41.69 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $10,715.19 / $11,220.18
| Facility | | $9,549.93 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $257.04 / $309.03
| Professional | | $218.78 | $257.04 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $30.20 / $35.48 / $43.65
| Professional | AS | $30.20 | $35.48 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $316.23 / $407.38
| Facility | | $239.88 | $316.23 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $295.12 / $380.19
| Professional | | $245.47 | $295.12 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $436.52 / $436.52
| Facility | | $34.67 | $436.52 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $524.81 / $524.81 / $524.81
| Facility | 22 | $524.81 | $524.81 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $275.42 / $275.42 / $275.42
| Facility | 62 | $275.42 | $275.42 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $43.65 / $43.65 / $43.65
| Facility | AS | $43.65 | $43.65 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $416.87 / $1,202.26
| Professional | | $263.03 | $416.87 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $218.78
| Professional | | $32.36 | $33.11 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $724.44 / $1,949.84
| Facility | | $58.88 | $724.44 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $323.59 / $537.03
| Professional | | $229.09 | $323.59 | $537.03 |