- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $4,786.30 / $11,220.18
| Facility | | $245.47 | $4,786.30 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $380.19 / $1,737.80
| Professional | | $190.55 | $380.19 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $288.40 / $389.05
| Professional | | $190.55 | $288.40 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $6,918.31 / $13,803.84
| Facility | | $891.25 | $6,918.31 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $229.09 / $275.42
| Professional | | $173.78 | $229.09 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $354.81 / $354.81
| Facility | | $354.81 | $354.81 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $426.58 / $426.58 / $426.58
| Facility | 22 | $426.58 | $426.58 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $223.87 / $223.87 / $223.87
| Facility | 62 | $223.87 | $223.87 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $35.48 / $35.48 / $35.48
| Facility | AS | $35.48 | $35.48 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $295.12 / $489.78
| Professional | | $181.97 | $295.12 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $2,754.23 / $3,019.95
| Facility | | $2,630.27 | $2,754.23 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $131.83 / $169.82 / $263.03
| Professional | | $131.83 | $169.82 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $309.03
| Professional | | $32.36 | $33.11 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $1,548.82 / $8,709.64
| Facility | | $331.13 | $1,548.82 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $234.42 / $446.68
| Professional | | $162.18 | $234.42 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $162.18 / $229.09
| Professional | | $162.18 | $162.18 | $229.09 |