- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $3,311.31 / $5,495.41
| Facility | | $1,548.82 | $3,311.31 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $81.28 / $81.28 / $151.36
| Facility | 53 | $81.28 | $81.28 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $323.59 / $1,737.80
| Professional | | $169.82 | $323.59 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $72.44 / $123.03 / $229.09
| Professional | 53 | $72.44 | $123.03 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $3,090.30 / $5,754.40
| Facility | | $1,584.89 | $3,090.30 | $5,754.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $407.38 / $1,174.90
| Professional | | $213.80 | $407.38 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $107.15 / $223.87 / $575.44
| Professional | 53 | $107.15 | $223.87 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $173.78 / $316.23
| Facility | | $24.55 | $173.78 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $91.20 / $724.44
| Professional | | $38.90 | $91.20 | $724.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $912.01 / $1,071.52 / $1,698.24
| Facility | | $912.01 | $1,071.52 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $446.68 / $446.68 / $446.68
| Facility | 22 | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $295.12 / $295.12 / $295.12
| Facility | 52 | $295.12 | $295.12 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $74.13 / $74.13 / $74.13
| Facility | 53 | $74.13 | $74.13 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $467.74 / $1,318.26
| Professional | | $245.47 | $467.74 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $131.83 / $245.47 / $660.69
| Professional | 53 | $131.83 | $245.47 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $316.23 / $3,311.31
| Facility | | $169.82 | $316.23 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $537.03 / $851.14
| Professional | | $316.23 | $537.03 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $371.54 / $3,311.31
| Facility | | $177.83 | $371.54 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $660.69 / $660.69 / $660.69
| Facility | 52 | $660.69 | $660.69 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $165.96 / $165.96 / $165.96
| Facility | 53 | $165.96 | $165.96 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $707.95 / $2,187.76
| Professional | | $346.74 | $707.95 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $186.21
| Professional | | $32.36 | $33.11 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,019.95 / $3,235.94
| Facility | | $1,819.70 | $3,019.95 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $616.60 / $1,258.93
| Professional | | $363.08 | $616.60 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $144.54 / $239.88 / $436.52
| Professional | 53 | $144.54 | $239.88 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $575.44 / $1,230.27
| Professional | | $288.40 | $575.44 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $371.54 / $1,862.09 / $2,754.23
| Facility | | $371.54 | $1,862.09 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $446.68 / $446.68 / $446.68
| Facility | 22 | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $295.12 / $1,513.56 / $2,238.72
| Facility | 52 | $295.12 | $1,513.56 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $74.13 / $380.19 / $549.54
| Facility | 53 | $74.13 | $380.19 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $794.33 / $2,187.76
| Professional | | $302.00 | $794.33 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $131.83 / $245.47 / $660.69
| Professional | 53 | $131.83 | $245.47 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $660.69 / $1,288.25
| Professional | | $660.69 | $660.69 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $165.96 / $165.96 / $323.59
| Professional | 53 | $165.96 | $165.96 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $912.01 / $1,737.80
| Professional | | $288.40 | $912.01 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $144.54 / $234.42 / $436.52
| Professional | 53 | $144.54 | $234.42 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $2,754.23 / $5,011.87
| Facility | | $2,344.23 | $2,754.23 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $416.87 / $758.58
| Professional | | $87.10 | $416.87 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $83.18 / $186.21 / $239.88
| Professional | 53 | $83.18 | $186.21 | $239.88 |