- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $4,466.84 / $9,120.11
| Facility | | $537.03 | $4,466.84 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $446.68 / $977.24
| Professional | | $245.47 | $446.68 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $104.71 / $114.82 / $812.83
| Professional | 53 | $104.71 | $114.82 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $223.87 / $371.54
| Professional | | $194.98 | $223.87 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $389.05 / $389.05 / $389.05
| Professional | 53 | $389.05 | $389.05 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $1,380.38 / $2,570.40
| Facility | | $575.44 | $1,380.38 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $562.34 / $954.99
| Professional | | $229.09 | $562.34 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $562.34 / $831.76
| Facility | | $426.58 | $562.34 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $501.19 / $954.99
| Professional | | $302.00 | $501.19 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $812.83 / $870.96
| Professional | | $741.31 | $812.83 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $524.81 / $912.01
| Facility | | $288.40 | $524.81 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $4,897.79 / $8,912.51
| Facility | | $891.25 | $4,897.79 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $436.52 / $812.83
| Professional | | $245.47 | $436.52 | $812.83 |