- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.87 / $398.11 / $5,370.32
| Facility | | $0.87 | $398.11 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $4,570.88 / $7,079.46
| Facility | | $2,630.27 | $4,570.88 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $588.84 / $933.25
| Facility | | $501.19 | $588.84 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $269.15 / $269.15 / $269.15
| Facility | 52 | $269.15 | $269.15 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $67.61 / $67.61 / $67.61
| Facility | 53 | $67.61 | $67.61 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $208.93 / $208.93 / $208.93
| Facility | 62 | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $33.88
| Facility | AS | $33.88 | $33.88 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $338.84 / $3,548.13
| Facility | | $194.98 | $338.84 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $380.19 / $4,897.79
| Facility | | $194.98 | $380.19 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $3,715.35 / $3,715.35 / $3,715.35
| Facility | 52 | $3,715.35 | $3,715.35 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $933.25 / $933.25 / $933.25
| Facility | 53 | $933.25 | $933.25 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $2,884.03 / $2,884.03 / $2,884.03
| Facility | 62 | $2,884.03 | $2,884.03 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $467.74 / $467.74 / $467.74
| Facility | AS | $467.74 | $467.74 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $3,890.45 / $4,570.88
| Facility | | $501.19 | $3,890.45 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $416.87 / $645.65
| Professional | | $234.42 | $416.87 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $4,897.79 / $4,897.79
| Facility | | $338.84 | $4,897.79 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $269.15 / $2,630.27 / $3,890.45
| Facility | 52 | $269.15 | $2,630.27 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $67.61 / $660.69 / $977.24
| Facility | 53 | $67.61 | $660.69 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $208.93 / $2,089.30 / $3,090.30
| Facility | 62 | $208.93 | $2,089.30 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $33.88 / $331.13 / $489.78
| Facility | AS | $33.88 | $331.13 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $724.44 / $724.44
| Professional | | $724.44 | $724.44 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $3,548.13 / $6,760.83
| Facility | | $2,754.23 | $3,548.13 | $6,760.83 |