- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $9,772.37 / $52,480.75
| Facility | | $1,318.26 | $9,772.37 | $52,480.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $812.83 / $2,290.87
| Professional | | $524.81 | $812.83 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $19,952.62 / $91,201.08
| Facility | | $6,165.95 | $19,952.62 | $91,201.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $707.95 / $1,548.82
| Professional | | $537.03 | $707.95 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $812.83 / $15,135.61
| Facility | | $812.83 | $812.83 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $812.83 / $812.83
| Professional | | $812.83 | $812.83 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19,054.61 / $35,481.34 / $51,286.14
| Facility | | $19,054.61 | $35,481.34 | $51,286.14 |
- 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
- $630.96 / $1,000.00 / $2,187.76
| Professional | | $630.96 | $1,000.00 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $851.14 / $3,388.44
| Facility | | $562.34 | $851.14 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $724.44 / $1,047.13
| Professional | | $537.03 | $724.44 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $660.69 / $1,047.13
| Professional | | $478.63 | $660.69 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,000.00 / $25,118.86 / $30,902.95
| Facility | | $10,000.00 | $25,118.86 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $16,982.44 / $75,857.76
| Facility | | $676.08 | $16,982.44 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $812.83 / $954.99
| Professional | | $645.65 | $812.83 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $10,232.93 / $37,153.52
| Facility | | $2,754.23 | $10,232.93 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $794.33 / $1,862.09
| Professional | | $524.81 | $794.33 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $776.25 / $1,621.81
| Facility | | $457.09 | $776.25 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $776.25 / $1,513.56
| Professional | | $457.09 | $776.25 | $1,513.56 |