- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $7,943.28 / $14,125.38
| Facility | | $1,513.56 | $7,943.28 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $1,122.02 / $1,148.15 / $10,471.29
| Facility | 52 | $1,122.02 | $1,148.15 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $2,187.76 / $2,187.76 / $2,187.76
| Facility | 53 | $2,187.76 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $501.19 / $2,290.87
| Professional | | $223.87 | $501.19 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $69.18 / $77.62 / $177.83
| Professional | 53 | $69.18 | $77.62 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $288.40 / $1,230.27
| Professional | | $204.17 | $288.40 | $1,230.27 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $288.40 / $288.40 / $1,096.48
| Professional | 53 | $288.40 | $288.40 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $3,388.44 / $12,302.69
| Facility | | $977.24 | $3,388.44 | $12,302.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $346.74 / $1,348.96
| Professional | | $239.88 | $346.74 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $12,589.25 / $53,703.18
| Facility | | $1,659.59 | $12,589.25 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $467.74 / $467.74 / $467.74
| Facility | 22 | $467.74 | $467.74 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $316.23 / $316.23 / $316.23
| Facility | 52 | $316.23 | $316.23 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $79.43
| Facility | 53 | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $446.68 / $2,089.30
| Professional | | $234.42 | $446.68 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $12,022.64 / $22,908.68
| Facility | | $6,165.95 | $12,022.64 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $870.96 / $1,174.90
| Professional | | $331.13 | $870.96 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $831.76
| Professional | | $32.36 | $33.11 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $5,495.41 / $9,772.37
| Facility | | $1,737.80 | $5,495.41 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $416.87 / $1,995.26
| Professional | | $229.09 | $416.87 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $478.63 / $1,288.25
| Professional | | $177.83 | $478.63 | $1,288.25 |