- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $4,466.84 / $9,772.37
| Facility | | $870.96 | $4,466.84 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $478.63 / $1,096.48
| Professional | | $380.19 | $478.63 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $398.11 / $776.25
| Professional | | $218.78 | $398.11 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $3,388.44 / $11,220.18
| Facility | | $870.96 | $3,388.44 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $446.68 / $501.19
| Professional | | $338.84 | $446.68 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $1,584.89 / $1,698.24
| Facility | | $436.52 | $1,584.89 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $575.44 / $575.44 / $575.44
| Facility | 52 | $575.44 | $575.44 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $72.44 / $72.44 / $72.44
| Facility | AS | $72.44 | $72.44 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $549.54 / $912.01
| Professional | | $346.74 | $549.54 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $13,489.63 / $23,988.33
| Facility | | $6,456.54 | $13,489.63 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $323.59 / $537.03
| Professional | | $257.04 | $323.59 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $616.60
| Professional | | $32.36 | $33.11 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $5,623.41 / $9,772.37
| Facility | | $1,905.46 | $5,623.41 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $457.09 / $870.96
| Professional | | $323.59 | $457.09 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $323.59 / $436.52
| Professional | | $323.59 | $323.59 | $436.52 |