- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $1,412.54 / $3,801.89
| Facility | | $346.74 | $1,412.54 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $190.55 / $316.23 / $316.23
| Facility | 52 | $190.55 | $316.23 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $158.49 / $467.74
| Professional | | $75.86 | $158.49 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $69.18 / $144.54 / $281.84
| Professional | 52 | $69.18 | $144.54 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $26.92 / $61.66 / $120.23
| Professional | 53 | $26.92 | $61.66 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $562.34 / $3,890.45
| Facility | | $56.23 | $562.34 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $323.59 / $323.59 / $323.59
| Facility | 52 | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $81.28 / $81.28 / $81.28
| Facility | 53 | $81.28 | $81.28 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $131.83 / $302.00
| Professional | | $67.61 | $131.83 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $70.79 / $162.18
| Facility | | $70.79 | $70.79 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $123.03 / $218.78
| Professional | | $70.79 | $123.03 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $57.54 / $97.72 / $162.18
| Professional | 52 | $57.54 | $97.72 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $25.12 / $50.12 / $81.28
| Professional | 53 | $25.12 | $50.12 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $151.36 / $309.03
| Professional | | $81.28 | $151.36 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $234.42 / $234.42 / $234.42
| Professional | 53 | $234.42 | $234.42 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $69.18 / $3,311.31
| Facility | | $33.88 | $69.18 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $109.65 / $162.18
| Professional | | $60.26 | $109.65 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $2,041.74 / $3,467.37
| Facility | | $741.31 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $117.49 / $251.19
| Professional | | $66.07 | $117.49 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $537.03 / $616.60
| Facility | | $398.11 | $537.03 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $186.21 / $190.55
| Professional | | $151.36 | $186.21 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $562.34 / $3,890.45
| Facility | | $56.23 | $562.34 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $323.59 / $323.59 / $323.59
| Facility | 52 | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $81.28 / $81.28 / $81.28
| Facility | 53 | $81.28 | $81.28 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $131.83 / $302.00
| Professional | | $67.61 | $131.83 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $338.84 / $489.78
| Facility | | $46.77 | $338.84 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $89.13 / $169.82
| Professional | | $89.13 | $89.13 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $1,698.24 / $2,818.38
| Facility | | $501.19 | $1,698.24 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $138.04 / $263.03
| Professional | | $81.28 | $138.04 | $263.03 |