- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $2,818.38 / $8,317.64
| Facility | | $537.03 | $2,818.38 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $1,584.89 / $2,398.83 / $2,398.83
| Facility | 52 | $1,584.89 | $2,398.83 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $630.96 / $1,445.44
| Professional | | $190.55 | $630.96 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $4,570.88 / $22,387.21
| Facility | | $3,019.95 | $4,570.88 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $208.93 / $208.93
| Professional | | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $6,165.95 / $57,543.99
| Facility | | $5,011.87 | $6,165.95 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,230.27 / $1,548.82
| Professional | | $741.31 | $1,230.27 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $436.52 / $1,412.54
| Professional | | $229.09 | $436.52 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,445.44 / $1,479.11
| Professional | | $1,445.44 | $1,445.44 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $977.24 / $1,479.11
| Professional | | $251.19 | $977.24 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $4,365.16 / $8,912.51
| Facility | | $1,905.46 | $4,365.16 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $7,244.36 / $7,244.36 / $11,748.98
| Facility | 50 | $7,244.36 | $7,244.36 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $3,890.45 / $3,890.45 / $3,890.45
| Facility | 52 | $3,890.45 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $3,630.78 / $9,549.93
| Facility | | $2,344.23 | $3,630.78 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $208.93 / $208.93
| Professional | | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $1,584.89 / $6,165.95
| Facility | | $302.00 | $1,584.89 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $707.95 / $1,862.09
| Professional | | $204.17 | $707.95 | $1,862.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $1,071.52 / $1,819.70
| Professional | | $234.42 | $1,071.52 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $199.53 / $891.25
| Facility | | $58.88 | $199.53 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $204.17 / $891.25
| Professional | | $58.88 | $204.17 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $3,715.35 / $6,760.83
| Facility | | $1,737.80 | $3,715.35 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $602.56 / $1,412.54
| Professional | | $204.17 | $602.56 | $1,412.54 |