- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $1,905.46 / $5,495.41
| Facility | | $426.58 | $1,905.46 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $416.87 / $776.25
| Professional | | $316.23 | $416.87 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $363.08 / $398.11
| Professional | | $338.84 | $363.08 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,019.95 / $6,165.95
| Facility | | $1,584.89 | $3,019.95 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $302.00 / $407.38
| Professional | | $251.19 | $302.00 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $398.11 / $512.86
| Facility | | $302.00 | $398.11 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $380.19 / $489.78
| Professional | | $302.00 | $380.19 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $562.34 / $562.34
| Facility | | $34.67 | $562.34 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $676.08 / $676.08 / $676.08
| Facility | 22 | $676.08 | $676.08 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $446.68 / $446.68 / $446.68
| Facility | 52 | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $112.20 / $112.20 / $112.20
| Facility | 53 | $112.20 | $112.20 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $478.63 / $1,513.56
| Professional | | $302.00 | $478.63 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $309.03
| Professional | | $32.36 | $33.11 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $2,089.30 / $4,168.69
| Facility | | $524.81 | $2,089.30 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $416.87 / $660.69
| Professional | | $288.40 | $416.87 | $660.69 |