- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $2,691.53 / $7,244.36
| Facility | | $91.20 | $2,691.53 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $851.14 / $1,819.70 / $1,819.70
| Facility | 52 | $851.14 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $125.89 / $346.74
| Professional | | $53.70 | $125.89 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $50.12 / $70.79
| Professional | | $23.99 | $50.12 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,630.78 / $5,011.87
| Facility | | $1,819.70 | $3,630.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $162.18 / $331.13
| Professional | | $138.04 | $162.18 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $77.62 / $4,073.80
| Facility | | $77.62 | $77.62 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $77.62 / $269.15
| Professional | | $77.62 | $77.62 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $1,023.29 / $50,118.72
| Facility | | $95.50 | $1,023.29 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Facility | 52 | $75.86 | $75.86 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $19.05
| Facility | 53 | $19.05 | $19.05 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $194.98 / $562.34
| Professional | | $66.07 | $194.98 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $97.72 / $208.93
| Facility | | $60.26 | $97.72 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $229.09 / $436.52
| Professional | | $114.82 | $229.09 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $169.82 / $169.82
| Facility | | $169.82 | $169.82 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $245.47 / $389.05
| Professional | | $128.82 | $245.47 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $933.25 / $3,090.30
| Facility | | $407.38 | $933.25 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $79.43 / $251.19
| Professional | | $72.44 | $79.43 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $50,118.72 / $75,857.76
| Facility | | $64.57 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $354.81 / $489.78
| Professional | | $208.93 | $354.81 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $2,884.03 / $5,248.07
| Facility | | $1,318.26 | $2,884.03 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $138.04 / $501.19
| Professional | | $57.54 | $138.04 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $81.28 / $371.54
| Facility | | $45.71 | $81.28 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $239.88 / $389.05
| Professional | | $128.82 | $239.88 | $389.05 |