- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $4,365.16 / $6,918.31
| Facility | | $588.84 | $4,365.16 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $446.68 / $2,041.74
| Professional | | $194.98 | $446.68 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $199.53 / $354.81 / $1,318.26
| Professional | 52 | $199.53 | $354.81 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $87.10 / $141.25 / $524.81
| Professional | 53 | $87.10 | $141.25 | $524.81 |
- 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
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $398.11 / $1,148.15
| Professional | | $239.88 | $398.11 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $245.47 / $389.05
| Facility | | $186.21 | $245.47 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $478.63 / $912.01
| Professional | | $380.19 | $478.63 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,348.96 / $2,187.76
| Facility | | $1,174.90 | $1,348.96 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $407.38 / $407.38 / $407.38
| Facility | 22 | $407.38 | $407.38 | $407.38 |
- 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
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $707.95 / $1,659.59
| Professional | | $269.15 | $707.95 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $457.09 / $3,311.31
| Facility | | $208.93 | $457.09 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $707.95 / $1,174.90
| Professional | | $363.08 | $707.95 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $1,174.90 / $3,311.31
| Facility | | $229.09 | $1,174.90 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $724.44 / $724.44 / $724.44
| Facility | 52 | $724.44 | $724.44 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $181.97 / $181.97 / $181.97
| Facility | 53 | $181.97 | $181.97 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $933.25 / $3,235.94
| Professional | | $416.87 | $933.25 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $87.10 / $87.10 / $1,445.44
| Professional | 53 | $87.10 | $87.10 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $346.74
| Professional | | $32.36 | $33.11 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $3,890.45 / $4,570.88
| Facility | | $512.86 | $3,890.45 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $776.25 / $1,479.11
| Professional | | $467.74 | $776.25 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $724.44 / $1,584.89
| Professional | | $316.23 | $724.44 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $3,630.78 / $3,630.78
| Facility | | $338.84 | $3,630.78 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $407.38 / $407.38 / $407.38
| Facility | 22 | $407.38 | $407.38 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $269.15 / $1,949.84 / $2,884.03
| Facility | 52 | $269.15 | $1,949.84 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $67.61 / $489.78 / $724.44
| Facility | 53 | $67.61 | $489.78 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $977.24 / $3,162.28
| Professional | | $263.03 | $977.24 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $724.44 / $1,659.59
| Professional | | $724.44 | $724.44 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,412.54 / $1,905.46
| Professional | | $724.44 | $1,412.54 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $3,311.31 / $6,606.93
| Facility | | $2,754.23 | $3,311.31 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $645.65 / $1,513.56
| Professional | | $95.50 | $645.65 | $1,513.56 |