- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $2,137.96 / $7,585.78
| Facility | | $549.54 | $2,137.96 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $309.03 / $1,023.29
| Professional | | $223.87 | $309.03 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $15.49 / $30.20 / $102.33
| Professional | AS | $15.49 | $30.20 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $251.19 / $316.23
| Professional | | $199.53 | $251.19 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $38.02 / $45.71 / $50.12
| Professional | AS | $38.02 | $45.71 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,912.51 / $14,125.38 / $22,908.68
| Facility | | $8,912.51 | $14,125.38 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $309.03 / $346.74
| Professional | | $245.47 | $309.03 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $363.08 / $446.68
| Professional | | $281.84 | $363.08 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $524.81 / $4,168.69
| Facility | | $234.42 | $524.81 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $389.05 / $724.44 / $724.44
| Facility | 62 | $389.05 | $724.44 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $61.66 / $117.49 / $117.49
| Facility | AS | $61.66 | $117.49 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $295.12 / $489.78
| Professional | | $223.87 | $295.12 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $602.56 / $1,584.89
| Facility | | $138.04 | $602.56 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $269.15 / $389.05
| Professional | | $208.93 | $269.15 | $389.05 |