- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $4,265.80 / $9,772.37
| Facility | | $398.11 | $4,265.80 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $457.09 / $1,778.28
| Professional | | $190.55 | $457.09 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $165.96 / $169.82
| Professional | | $154.88 | $165.96 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $8,317.64 / $13,803.84
| Facility | | $2,344.23 | $8,317.64 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $302.00 / $478.63
| Professional | | $218.78 | $302.00 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $229.09 / $309.03
| Professional | | $190.55 | $229.09 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,715.19 / $17,378.01 / $22,387.21
| Facility | | $10,715.19 | $17,378.01 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $295.12 / $630.96
| Professional | | $218.78 | $295.12 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $338.84 / $5,888.44
| Facility | | $190.55 | $338.84 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $316.23 / $602.56 / $602.56
| Facility | 62 | $316.23 | $602.56 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $50.12 / $95.50 / $95.50
| Facility | AS | $50.12 | $95.50 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $331.13 / $3,630.78
| Professional | | $204.17 | $331.13 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $707.95 / $9,549.93
| Facility | | $338.84 | $707.95 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $275.42 / $436.52
| Professional | | $186.21 | $275.42 | $436.52 |