- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,995.26 / $6,309.57
| Facility | | $323.59 | $1,995.26 | $6,309.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $234.42 / $467.74
| Professional | | $77.62 | $234.42 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $45.71 / $147.91 / $147.91
| Professional | 52 | $45.71 | $147.91 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $26.30 / $34.67 / $34.67
| Professional | 53 | $26.30 | $34.67 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $208.93 / $269.15
| Professional | | $69.18 | $208.93 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $51.29 / $51.29 / $64.57
| Professional | 52 | $51.29 | $51.29 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $281.84 / $281.84 / $281.84
| Professional | 53 | $281.84 | $281.84 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $912.01 / $1,905.46
| Facility | | $562.34 | $912.01 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $158.49 / $275.42
| Professional | | $64.57 | $158.49 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $758.58 / $1,584.89
| Facility | | $501.19 | $758.58 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $213.80 / $346.74
| Professional | | $77.62 | $213.80 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $512.86 / $512.86
| Facility | | $70.79 | $512.86 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $457.09 / $457.09
| Facility | | $457.09 | $457.09 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $229.09 / $389.05
| Professional | | $91.20 | $229.09 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $19,498.45 / $19,498.45
| Facility | | $2,290.87 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $1,380.38 / $1,380.38 / $1,380.38
| Facility | 52 | $1,380.38 | $1,380.38 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $346.74 / $346.74 / $346.74
| Facility | 53 | $346.74 | $346.74 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $1,862.09 / $1,862.09
| Professional | | $1,584.89 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $295.12 / $3,630.78
| Facility | | $95.50 | $295.12 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $234.42 / $436.52
| Professional | | $81.28 | $234.42 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $45.71 / $85.11 / $147.91
| Professional | 52 | $45.71 | $85.11 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $34.67 / $34.67 / $34.67
| Professional | 53 | $34.67 | $34.67 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $173.78
| Professional | | $32.36 | $33.11 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $2,137.96 / $3,311.31
| Facility | | $2,137.96 | $2,137.96 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $398.11 / $660.69
| Professional | | $3.02 | $398.11 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $223.87 / $407.38
| Facility | | $83.18 | $223.87 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $223.87 / $389.05
| Professional | | $91.20 | $223.87 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $1,445.44 / $3,548.13
| Facility | | $436.52 | $1,445.44 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $173.78 / $309.03
| Professional | | $83.18 | $173.78 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $218.78 / $218.78
| Professional | | $208.93 | $218.78 | $218.78 |