- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,818.38 / $6,760.83 / $20,417.38
| Facility | | $2,818.38 | $6,760.83 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $812.83 / $2,511.89
| Professional | | $537.03 | $812.83 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $6,025.60 / $32,359.37
| Facility | | $1,348.96 | $6,025.60 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $33,113.11 / $33,113.11 / $33,113.11
| Facility | 52 | $33,113.11 | $33,113.11 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $8,128.31 / $8,128.31 / $8,128.31
| Facility | 53 | $8,128.31 | $8,128.31 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $831.76 / $2,630.27
| Professional | | $436.52 | $831.76 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $15,848.93 / $21,877.62
| Facility | | $7,762.47 | $15,848.93 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,202.26 / $1,737.80
| Professional | | $812.83 | $1,202.26 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $588.84 / $3,467.37
| Facility | | $288.40 | $588.84 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $501.19 / $758.58
| Professional | | $275.42 | $501.19 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $7,244.36 / $30,902.95
| Facility | | $3,090.30 | $7,244.36 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $851.14 / $1,659.59
| Professional | | $478.63 | $851.14 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13,489.63 / $14,791.08 / $15,488.17
| Facility | | $13,489.63 | $14,791.08 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $6,025.60 / $32,359.37
| Facility | | $1,348.96 | $6,025.60 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $33,113.11 / $33,113.11 / $33,113.11
| Facility | 52 | $33,113.11 | $33,113.11 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $8,128.31 / $8,128.31 / $8,128.31
| Facility | 53 | $8,128.31 | $8,128.31 | $8,128.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $831.76 / $2,630.27
| Professional | | $436.52 | $831.76 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,570.40 / $7,244.36 / $32,359.37
| Facility | | $2,570.40 | $7,244.36 | $32,359.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $1,023.29 / $2,398.83
| Professional | | $575.44 | $1,023.29 | $2,398.83 |