- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $2,454.71 / $7,762.47
| Facility | | $63.10 | $2,454.71 | $7,762.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $87.10 / $190.55
| Professional | | $46.77 | $87.10 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $30.20
| Professional | 52 | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,630.78 / $5,011.87
| Facility | | $1,819.70 | $3,630.78 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $85.11 / $194.98
| Professional | | $67.61 | $85.11 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $66.07 / $4,073.80
| Facility | | $66.07 | $66.07 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $66.07 / $102.33
| Professional | | $66.07 | $66.07 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $79.43 / $53,703.18
| Facility | | $34.67 | $79.43 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $112.20 / $263.03
| Professional | | $56.23 | $112.20 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $44.67 / $47.86 / $97.72
| Professional | 53 | $44.67 | $47.86 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $53.70 / $154.88
| Facility | | $44.67 | $53.70 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $102.33 / $144.54
| Professional | | $75.86 | $102.33 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $95.50 / $158.49
| Professional | | $64.57 | $95.50 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $151.36 / $151.36
| Professional | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $50,118.72 / $75,857.76
| Facility | | $50.12 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $102.33 / $398.11
| Professional | | $81.28 | $102.33 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $39.81 / $47.86 / $97.72
| Professional | 53 | $39.81 | $47.86 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $2,454.71 / $4,897.79
| Facility | | $1,071.52 | $2,454.71 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $89.13 / $186.21
| Professional | | $48.98 | $89.13 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $52.48 / $169.82
| Facility | | $37.15 | $52.48 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $89.13 / $158.49
| Professional | | $60.26 | $89.13 | $158.49 |