- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $5,128.61 / $15,135.61
| Facility | | $1,513.56 | $5,128.61 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $54.95 / $125.89 / $549.54
| Facility | 53 | $54.95 | $125.89 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $331.13 / $1,047.13
| Professional | | $173.78 | $331.13 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $60.26 / $128.82 / $371.54
| Professional | 53 | $60.26 | $128.82 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $173.78 / $245.47
| Professional | | $147.91 | $173.78 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $85.11 / $107.15 / $123.03
| Professional | 53 | $85.11 | $107.15 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $6,165.95 / $13,489.63
| Facility | | $3,548.13 | $6,165.95 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $229.09 / $416.87 / $794.33
| Professional | | $229.09 | $416.87 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $91.20 / $165.96 / $269.15
| Professional | 53 | $91.20 | $165.96 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $1,380.38 / $2,511.89
| Facility | | $85.11 | $1,380.38 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $398.11 / $776.25
| Professional | | $213.80 | $398.11 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $169.82 / $478.63 / $1,071.52
| Professional | 53 | $169.82 | $478.63 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $724.44 / $1,258.93
| Facility | | $575.44 | $724.44 | $1,258.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $302.00 / $302.00
| Professional | | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $107.15 / $131.83 / $229.09
| Professional | 53 | $107.15 | $131.83 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $489.78 / $660.69
| Professional | | $186.21 | $489.78 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $371.54 / $707.95
| Professional | | $165.96 | $371.54 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $83.18 / $186.21 / $346.74
| Professional | 53 | $83.18 | $186.21 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $2,884.03 / $28,840.32
| Facility | | $2,884.03 | $2,884.03 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $2,290.87 / $2,290.87 / $2,290.87
| Facility | 52 | $2,290.87 | $2,290.87 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $575.44 / $575.44 / $575.44
| Facility | 53 | $575.44 | $575.44 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,818.38 / $2,818.38
| Professional | | $2,187.76 | $2,818.38 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $120.23 / $120.23 / $251.19
| Professional | 53 | $120.23 | $120.23 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $346.74
| Professional | | $32.36 | $33.11 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $70.79
| Professional | | $54.95 | $54.95 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $338.84 / $630.96
| Facility | | $181.97 | $338.84 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $302.00 / $812.83
| Professional | | $302.00 | $302.00 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $107.15 / $123.03 / $269.15
| Professional | 53 | $107.15 | $123.03 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $1,621.81 / $1,621.81
| Facility | | $1,621.81 | $1,621.81 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $602.56 / $1,096.48
| Professional | | $602.56 | $602.56 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $302.00 / $302.00 / $549.54
| Professional | 53 | $302.00 | $302.00 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $2,818.38 / $7,585.78
| Facility | | $1,122.02 | $2,818.38 | $7,585.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $169.82 / $309.03 / $602.56
| Professional | | $169.82 | $309.03 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $100.00 / $181.97 / $295.12
| Professional | 53 | $100.00 | $181.97 | $295.12 |