- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $9,772.37 / $33,113.11
| Facility | | $1,148.15 | $9,772.37 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $776.25 / $1,778.28
| Professional | | $524.81 | $776.25 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $630.96 / $870.96
| Professional | | $489.78 | $630.96 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $10,471.29 / $40,738.03
| Facility | | $1,174.90 | $10,471.29 | $40,738.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $524.81 / $691.83
| Professional | | $398.11 | $524.81 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $17,378.01 / $38,018.94
| Facility | | $7,762.47 | $17,378.01 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $1,122.02 / $1,122.02 / $1,122.02
| Facility | 22 | $1,122.02 | $1,122.02 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $741.31 / $741.31 / $741.31
| Facility | 52 | $741.31 | $741.31 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $186.21 / $186.21 / $186.21
| Facility | 53 | $186.21 | $186.21 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $812.83 / $1,445.44
| Professional | | $524.81 | $812.83 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,218.10 / $26,302.68 / $48,977.88
| Facility | | $16,218.10 | $26,302.68 | $48,977.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $371.54 / $645.65
| Professional | | $346.74 | $371.54 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $741.31
| Professional | | $32.36 | $33.11 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $17,378.01 / $39,810.72
| Facility | | $4,365.16 | $17,378.01 | $39,810.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $776.25 / $1,412.54
| Professional | | $524.81 | $776.25 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $436.52 / $630.96
| Professional | | $436.52 | $436.52 | $630.96 |