- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $478.63 / $4,786.30
| Facility | | $67.61 | $478.63 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $169.82 / $169.82 / $602.56
| Facility | 52 | $169.82 | $169.82 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $67.61 / $169.82
| Professional | | $25.12 | $67.61 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $46.77 / $46.77
| Professional | | $46.77 | $46.77 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $10,964.78 / $17,378.01
| Facility | | $2,398.83 | $10,964.78 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $42.66
| Professional | | $33.88 | $33.88 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $75.86 / $114.82
| Professional | | $52.48 | $75.86 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $58.88 / $120.23
| Professional | | $27.54 | $58.88 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $107.15 / $112.20
| Professional | | $107.15 | $107.15 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $91.20 / $138.04
| Professional | | $31.62 | $91.20 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $354.81 / $691.83
| Facility | | $125.89 | $354.81 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $85.11 / $100.00
| Professional | | $50.12 | $85.11 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $7,244.36 / $15,135.61
| Facility | | $181.97 | $7,244.36 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $38.02
| Professional | | $33.88 | $33.88 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $537.03 / $5,754.40
| Facility | | $33.11 | $537.03 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $60.26 / $144.54
| Professional | | $25.12 | $60.26 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $109.65 / $151.36
| Professional | | $30.20 | $109.65 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $33.11 / $60.26
| Facility | | $15.14 | $33.11 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $33.11 / $60.26
| Professional | | $13.49 | $33.11 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $467.74 / $3,890.45
| Facility | | $213.80 | $467.74 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $53.70 / $112.20
| Professional | | $25.70 | $53.70 | $112.20 |