- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $2,511.89 / $6,918.31
| Facility | | $549.54 | $2,511.89 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $537.03 / $537.03 / $537.03
| Facility | 52 | $537.03 | $537.03 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $229.09 / $501.19
| Professional | | $100.00 | $229.09 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $109.65 / $288.40
| Professional | | $83.18 | $109.65 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $1,258.93 / $2,630.27
| Facility | | $676.08 | $1,258.93 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $208.93 / $354.81
| Professional | | $89.13 | $208.93 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,122.02 / $3,715.35
| Facility | | $724.44 | $1,122.02 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $100.00 / $213.80
| Professional | | $53.70 | $100.00 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $741.31 / $741.31
| Facility | | $93.33 | $741.31 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $660.69 / $851.14
| Facility | | $177.83 | $660.69 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $251.19 / $512.86
| Professional | | $114.82 | $251.19 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $2,818.38
| Facility | | $54.95 | $56.23 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $2,238.72 / $2,238.72 / $2,238.72
| Facility | 52 | $2,238.72 | $2,238.72 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $562.34 / $562.34 / $562.34
| Facility | 53 | $562.34 | $562.34 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $2,398.83 / $2,398.83
| Professional | | $2,041.74 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $316.23 / $2,398.83
| Facility | | $107.15 | $316.23 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $537.03 / $537.03 / $537.03
| Facility | 52 | $537.03 | $537.03 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $263.03 / $501.19
| Professional | | $102.33 | $263.03 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $245.47
| Professional | | $32.36 | $33.11 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $234.42 / $234.42
| Facility | | $158.49 | $234.42 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $354.81 / $758.58
| Professional | | $97.72 | $354.81 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $275.42 / $562.34
| Facility | | $104.71 | $275.42 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $263.03 / $537.03
| Professional | | $114.82 | $263.03 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $1,905.46 / $3,981.07
| Facility | | $724.44 | $1,905.46 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $229.09 / $457.09
| Professional | | $97.72 | $229.09 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $269.15 / $309.03
| Professional | | $81.28 | $269.15 | $309.03 |