- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $17,378.01 / $33,113.11
| Facility | | $1,778.28 | $17,378.01 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $21,877.62 / $21,877.62 / $21,877.62
| Facility | 50 | $21,877.62 | $21,877.62 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,995.26 / $5,248.07
| Professional | | $1,071.52 | $1,995.26 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $158.49 / $302.00 / $602.56
| Professional | AS | $158.49 | $302.00 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $1,000.00 / $1,621.81
| Professional | | $147.91 | $1,000.00 | $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
- $14,791.08 / $32,359.37 / $54,954.09
| Facility | | $14,791.08 | $32,359.37 | $54,954.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,995.26 / $3,090.30
| Professional | | $1,318.26 | $1,995.26 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $186.21 / $275.42 / $426.58
| Professional | AS | $186.21 | $275.42 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,445.44 / $1,659.59
| Facility | | $1,174.90 | $1,445.44 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,479.11 / $1,659.59
| Professional | | $1,174.90 | $1,479.11 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,589.25 / $12,589.25 / $15,135.61
| Facility | | $12,589.25 | $12,589.25 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,778.28 / $3,388.44
| Professional | | $1,258.93 | $1,778.28 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $13,803.84 / $24,547.09
| Facility | | $6,165.95 | $13,803.84 | $24,547.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,548.82 / $2,691.53
| Professional | | $1,122.02 | $1,548.82 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $660.69
| Professional | AS | $85.11 | $85.11 | $660.69 |