- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $7,943.28 / $19,054.61
| Facility | | $3,090.30 | $7,943.28 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $25,118.86 / $25,118.86 / $25,118.86
| Facility | 50 | $25,118.86 | $25,118.86 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $1,862.09 / $5,623.41
| Professional | | $602.56 | $1,862.09 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $158.49 / $371.54 / $954.99
| Professional | AS | $158.49 | $371.54 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $208.93 / $1,230.27
| Professional | | $165.96 | $208.93 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $14,454.40 / $27,542.29
| Facility | | $3,548.13 | $14,454.40 | $27,542.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,949.84 / $3,630.78
| Professional | | $1,513.56 | $1,949.84 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,584.89 / $2,630.27
| Professional | | $1,202.26 | $1,584.89 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,862.09 / $16,982.44
| Facility | | $1,258.93 | $1,862.09 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $2,290.87 / $2,290.87 / $35,481.34
| Facility | 54 | $2,290.87 | $2,290.87 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $2,041.74 / $2,041.74 / $31,622.78
| Facility | 62 | $2,041.74 | $2,041.74 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $323.59 / $323.59 / $5,128.61
| Facility | AS | $323.59 | $323.59 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,659.59 / $13,489.63
| Professional | | $1,202.26 | $1,659.59 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $11,220.18 / $18,620.87
| Facility | | $4,466.84 | $11,220.18 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,445.44 / $2,511.89
| Professional | | $1,148.15 | $1,445.44 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $660.69 / $660.69 / $660.69
| Professional | AS | $660.69 | $660.69 | $660.69 |