- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $2,570.40 / $8,317.64
| Facility | | $501.19 | $2,570.40 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $123.03 / $338.84
| Professional | | $93.33 | $123.03 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $43.65 / $61.66 / $309.03
| Professional | 52 | $43.65 | $61.66 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,258.93 / $57,543.99
| Facility | | $1,174.90 | $1,258.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $154.88 / $218.78
| Professional | | $128.82 | $154.88 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $141.25 / $229.09
| Professional | | $107.15 | $141.25 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $229.09 / $288.40
| Professional | | $165.96 | $229.09 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $169.82 / $234.42
| Professional | | $104.71 | $169.82 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $1,000.00 / $1,862.09
| Facility | | $676.08 | $1,000.00 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $851.14 / $851.14 / $2,818.38
| Facility | 52 | $851.14 | $851.14 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $1,905.46 / $6,606.93
| Facility | | $537.03 | $1,905.46 | $6,606.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $134.90 / $309.03
| Professional | | $97.72 | $134.90 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $239.88 / $295.12
| Professional | | $204.17 | $239.88 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $125.89 / $269.15
| Facility | | $89.13 | $125.89 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $134.90 / $309.03
| Professional | | $44.67 | $134.90 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $741.31 / $3,890.45
| Facility | | $363.08 | $741.31 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $131.83 / $218.78
| Professional | | $93.33 | $131.83 | $218.78 |