- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $3,388.44 / $7,079.46
| Facility | | $630.96 | $3,388.44 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $489.78 / $489.78 / $524.81
| Facility | 52 | $489.78 | $489.78 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $2,344.23 / $2,344.23 / $2,344.23
| Facility | 53 | $2,344.23 | $2,344.23 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $123.03 / $331.13
| Professional | | $53.70 | $123.03 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $52.48 / $52.48
| Professional | | $46.77 | $52.48 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $74.13 / $323.59
| Professional | | $48.98 | $74.13 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $95.50 / $95.50
| Facility | | $95.50 | $95.50 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $154.88 / $407.38
| Professional | | $63.10 | $154.88 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $223.87 / $436.52
| Professional | | $50.12 | $223.87 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $2,818.38 / $4,677.35
| Facility | | $1,819.70 | $2,818.38 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $162.18 / $323.59
| Professional | | $44.67 | $162.18 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $3,467.37 / $6,606.93
| Facility | | $1,698.24 | $3,467.37 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $123.03 / $302.00
| Professional | | $44.67 | $123.03 | $302.00 |