- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $11,748.98 / $25,118.86
| Facility | | $4,570.88 | $11,748.98 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $50,118.72 / $50,118.72 / $50,118.72
| Facility | 22 | $50,118.72 | $50,118.72 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $8,709.64 / $23,442.29 / $23,442.29
| Facility | 50 | $8,709.64 | $23,442.29 | $23,442.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $1,698.24 / $3,715.35
| Professional | | $501.19 | $1,698.24 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $162.18 / $302.00 / $691.83
| Professional | AS | $162.18 | $302.00 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $1,513.56 / $2,344.23
| Professional | | $204.17 | $1,513.56 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $7,079.46 / $28,183.83
| Facility | | $2,238.72 | $7,079.46 | $28,183.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,238.72 / $3,019.95
| Professional | | $1,479.11 | $2,238.72 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $204.17 / $309.03 / $426.58
| Professional | AS | $204.17 | $309.03 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,778.28 / $2,511.89
| Facility | | $1,513.56 | $1,778.28 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,548.82 / $1,778.28
| Professional | | $1,174.90 | $1,548.82 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $16,595.87 / $53,703.18
| Facility | | $12,882.50 | $16,595.87 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $2,137.96 / $3,467.37
| Professional | | $1,412.54 | $2,137.96 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,905.46 / $5,623.41
| Professional | | $1,318.26 | $1,905.46 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- 22
- Typical Low / Median / Typical High
- $3,801.89 / $3,801.89 / $3,801.89
| Professional | 22 | $3,801.89 | $3,801.89 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- 54
- Typical Low / Median / Typical High
- $1,778.28 / $1,778.28 / $1,778.28
| Professional | 54 | $1,778.28 | $1,778.28 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- 62
- Typical Low / Median / Typical High
- $1,174.90 / $1,174.90 / $1,174.90
| Professional | 62 | $1,174.90 | $1,174.90 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- 80
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Professional | 80 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $50.12
| Professional | AS | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $2,238.72 / $2,238.72
| Professional | | $1,995.26 | $2,238.72 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $9,120.11 / $25,118.86
| Facility | | $2,884.03 | $9,120.11 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,862.09 / $2,951.21
| Professional | | $1,202.26 | $1,862.09 | $2,951.21 |