- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $8,912.51 / $25,118.86
| Facility | | $2,187.76 | $8,912.51 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $22,387.21 / $22,387.21 / $22,387.21
| Facility | 22 | $22,387.21 | $22,387.21 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $20,417.38 / $20,417.38 / $20,417.38
| Facility | 50 | $20,417.38 | $20,417.38 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,949.84 / $5,623.41
| Professional | | $1,071.52 | $1,949.84 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $162.18 / $331.13 / $954.99
| Professional | AS | $162.18 | $331.13 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $1,096.48 / $1,621.81
| Professional | | $154.88 | $1,096.48 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $138.04 / $138.04 / $138.04
| Professional | AS | $138.04 | $138.04 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14,125.38 / $18,620.87 / $28,840.32
| Facility | | $14,125.38 | $18,620.87 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $2,187.76 / $2,630.27
| Professional | | $1,584.89 | $2,187.76 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,511.38 / $18,197.01 / $18,197.01
| Facility | | $8,511.38 | $18,197.01 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,905.46 / $3,090.30
| Professional | | $1,202.26 | $1,905.46 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $2,238.72 / $9,120.11
| Professional | | $1,412.54 | $2,238.72 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,659.59 / $1,819.70
| Professional | | $1,513.56 | $1,659.59 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,348.96
| Professional | | $32.36 | $33.11 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $10,964.78 / $26,302.68
| Facility | | $4,073.80 | $10,964.78 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,778.28 / $4,073.80
| Professional | | $1,122.02 | $1,778.28 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $660.69 / $660.69 / $660.69
| Professional | AS | $660.69 | $660.69 | $660.69 |