- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $1,995.26 / $6,309.57
| Facility | | $346.74 | $1,995.26 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $416.87 / $416.87 / $1,023.29
| Facility | 52 | $416.87 | $416.87 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $138.04 / $354.81
| Professional | | $53.70 | $138.04 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $53.70 / $114.82
| Professional | | $26.92 | $53.70 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $213.80 / $891.25
| Facility | | $128.82 | $213.80 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $151.36 / $234.42
| Professional | | $52.48 | $151.36 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $138.04 / $2,570.40
| Facility | | $79.43 | $138.04 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $77.62 / $208.93
| Professional | | $36.31 | $77.62 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $676.08 / $676.08
| Facility | | $52.48 | $676.08 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $213.80 / $354.81
| Facility | | $162.18 | $213.80 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $154.88 / $323.59
| Professional | | $63.10 | $154.88 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,951.21 / $13,489.63 / $13,489.63
| Facility | | $2,951.21 | $13,489.63 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $831.76 / $831.76 / $831.76
| Facility | 52 | $831.76 | $831.76 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $208.93 / $208.93 / $208.93
| Facility | 53 | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,584.89 / $1,584.89
| Professional | | $1,318.26 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $169.82 / $870.96
| Facility | | $58.88 | $169.82 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $416.87 / $416.87 / $1,023.29
| Facility | 52 | $416.87 | $416.87 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $141.25 / $354.81
| Professional | | $53.70 | $141.25 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $151.36
| Professional | | $32.36 | $33.11 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $2,137.96 / $3,311.31
| Facility | | $1,445.44 | $2,137.96 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $295.12 / $758.58
| Professional | | $117.49 | $295.12 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $147.91 / $316.23
| Facility | | $57.54 | $147.91 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $154.88 / $346.74
| Professional | | $63.10 | $154.88 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $1,412.54 / $3,467.37
| Facility | | $416.87 | $1,412.54 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $117.49 / $234.42
| Professional | | $52.48 | $117.49 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $204.17 / $234.42
| Professional | | $43.65 | $204.17 | $234.42 |