- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $1,819.70 / $7,244.36
| Facility | | $501.19 | $1,819.70 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $724.44 / $724.44 / $724.44
| Facility | 54 | $724.44 | $724.44 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $478.63 / $891.25
| Professional | | $389.05 | $478.63 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $2,691.53 / $57,543.99
| Facility | | $2,630.27 | $2,691.53 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $501.19 / $831.76
| Professional | | $489.78 | $501.19 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $537.03 / $891.25
| Professional | | $398.11 | $537.03 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $912.01 / $1,174.90
| Professional | | $676.08 | $912.01 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $588.84 / $933.25
| Professional | | $323.59 | $588.84 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $3,019.95 / $5,623.41
| Facility | | $562.34 | $3,019.95 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $6,760.83 / $6,760.83 / $6,760.83
| Facility | 54 | $6,760.83 | $6,760.83 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $489.78 / $524.81
| Professional | | $446.68 | $489.78 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $1,513.56 / $6,165.95
| Facility | | $446.68 | $1,513.56 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $537.03 / $1,023.29
| Professional | | $407.38 | $537.03 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $831.76 / $1,096.48
| Professional | | $602.56 | $831.76 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $407.38 / $478.63
| Facility | | $309.03 | $407.38 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $416.87 / $478.63
| Professional | | $309.03 | $416.87 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $2,570.40 / $5,370.32
| Facility | | $575.44 | $2,570.40 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $512.86 / $912.01
| Professional | | $380.19 | $512.86 | $912.01 |