- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $12,022.64 / $30,902.95
| Facility | | $1,621.81 | $12,022.64 | $30,902.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,819.70 / $4,168.69
| Professional | | $1,288.25 | $1,819.70 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $194.98 / $371.54 / $1,071.52
| Professional | AS | $194.98 | $371.54 | $1,071.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $1,548.82 / $2,344.23
| Professional | | $173.78 | $1,548.82 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $8,128.31 / $18,197.01
| Facility | | $1,380.38 | $8,128.31 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,548.82 / $1,737.80
| Professional | | $1,148.15 | $1,548.82 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $13,489.63 / $14,791.08
| Facility | | $323.59 | $13,489.63 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $2,951.21 / $2,951.21 / $2,951.21
| Facility | 22 | $2,951.21 | $2,951.21 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $245.47 / $245.47 / $245.47
| Facility | AS | $245.47 | $245.47 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,862.09 / $3,090.30
| Professional | | $1,202.26 | $1,862.09 | $3,090.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,760.83 / $13,489.63 / $23,988.33
| Facility | | $6,760.83 | $13,489.63 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $1,071.52 / $1,548.82
| Professional | | $851.14 | $1,071.52 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $2,089.30
| Professional | | $32.36 | $33.11 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,025.60 / $16,595.87 / $42,657.95
| Facility | | $6,025.60 | $16,595.87 | $42,657.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,548.82 / $2,951.21
| Professional | | $1,071.52 | $1,548.82 | $2,951.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,122.02 / $1,513.56
| Professional | | $1,122.02 | $1,122.02 | $1,513.56 |