- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $3,388.44 / $12,589.25
| Facility | | $407.38 | $3,388.44 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $549.54 / $1,548.82
| Professional | | $389.05 | $549.54 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $7,943.28 / $13,182.57
| Facility | | $5,011.87 | $7,943.28 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $851.14 / $2,344.23
| Professional | | $416.87 | $851.14 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,288.25 / $2,137.96
| Facility | | $1,096.48 | $1,288.25 | $2,137.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $1,737.80 / $1,949.84
| Professional | | $537.03 | $1,737.80 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $870.96 / $4,168.69
| Facility | | $416.87 | $870.96 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,000.00 / $1,318.26
| Professional | | $741.31 | $1,000.00 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $977.24 / $8,317.64
| Facility | | $426.58 | $977.24 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $831.76 / $3,235.94
| Professional | | $457.09 | $831.76 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $5,754.40 / $7,762.47
| Facility | | $870.96 | $5,754.40 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $1,047.13 / $1,778.28
| Professional | | $524.81 | $1,047.13 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $954.99 / $1,380.38
| Professional | | $630.96 | $954.99 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $8,912.51 / $8,912.51
| Facility | | $6,025.60 | $8,912.51 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $4,897.79 / $4,897.79 / $7,244.36
| Facility | 52 | $4,897.79 | $4,897.79 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $602.56 / $602.56 / $891.25
| Facility | AS | $602.56 | $602.56 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $2,041.74 / $3,388.44
| Professional | | $741.31 | $2,041.74 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,380.38 / $1,380.38
| Professional | | $1,380.38 | $1,380.38 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $2,344.23 / $2,691.53
| Professional | | $831.76 | $2,344.23 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $7,585.78 / $9,120.11
| Facility | | $4,786.30 | $7,585.78 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $741.31 / $2,511.89
| Professional | | $89.13 | $741.31 | $2,511.89 |