- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $851.14 / $6,606.93
| Facility | | $346.74 | $851.14 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $660.69 / $691.83 / $851.14
| Facility | 54 | $660.69 | $691.83 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $446.68 / $831.76
| Professional | | $281.84 | $446.68 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,047.13 / $1,047.13 / $1,047.13
| Professional | 50 | $1,047.13 | $1,047.13 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- 54
- Typical Low / Median / Typical High
- $288.40 / $380.19 / $478.63
| Professional | 54 | $288.40 | $380.19 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $181.97 / $213.80
| Professional | | $117.49 | $181.97 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $4,897.79 / $7,762.47
| Facility | | $1,071.52 | $4,897.79 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $363.08 / $398.11
| Professional | | $177.83 | $363.08 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,258.93 / $57,543.99
| Facility | | $1,174.90 | $1,258.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $501.19 / $588.84
| Professional | | $346.74 | $501.19 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $524.81 / $741.31 / $891.25
| Professional | 50 | $524.81 | $741.31 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $371.54 / $630.96
| Professional | | $257.04 | $371.54 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $630.96 / $794.33
| Professional | | $457.09 | $630.96 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $446.68 / $630.96
| Professional | | $263.03 | $446.68 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $588.84 / $1,071.52
| Facility | | $295.12 | $588.84 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $912.01 / $912.01 / $912.01
| Facility | 54 | $912.01 | $912.01 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $363.08 / $446.68
| Professional | | $316.23 | $363.08 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $501.19 / $562.34 / $630.96
| Professional | 50 | $501.19 | $562.34 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- 54
- Typical Low / Median / Typical High
- $177.83 / $239.88 / $251.19
| Professional | 54 | $177.83 | $239.88 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $3,388.44 / $6,760.83
| Facility | | $331.13 | $3,388.44 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $363.08 / $398.11
| Professional | | $177.83 | $363.08 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $1,348.96 / $6,165.95
| Facility | | $363.08 | $1,348.96 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $389.05 / $724.44
| Professional | | $295.12 | $389.05 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $501.19 / $776.25
| Professional | | $331.13 | $501.19 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $269.15 / $338.84
| Facility | | $70.79 | $269.15 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $309.03 / $363.08
| Professional | | $70.79 | $309.03 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $676.08 / $3,890.45
| Facility | | $354.81 | $676.08 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $354.81 / $645.65
| Professional | | $251.19 | $354.81 | $645.65 |