- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,041.74 / $7,943.28 / $16,982.44
| Facility | | $2,041.74 | $7,943.28 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $11,481.54 / $11,481.54 / $11,481.54
| Facility | 50 | $11,481.54 | $11,481.54 | $11,481.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,698.24 / $3,548.13
| Professional | | $1,071.52 | $1,698.24 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $158.49 / $288.40 / $741.31
| Professional | AS | $158.49 | $288.40 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $1,000.00 / $1,548.82
| Professional | | $154.88 | $1,000.00 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $309.03 / $309.03 / $309.03
| Professional | AS | $309.03 | $309.03 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,232.93 / $34,673.69 / $34,673.69
| Facility | | $10,232.93 | $34,673.69 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,479.11 / $2,187.76
| Professional | | $1,202.26 | $1,479.11 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $169.82 / $204.17 / $302.00
| Professional | AS | $169.82 | $204.17 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,548.82 / $2,041.74
| Facility | | $1,202.26 | $1,548.82 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,479.11 / $1,905.46
| Professional | | $1,202.26 | $1,479.11 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $2,187.76 / $2,187.76
| Facility | | $34.67 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $2,630.27 / $2,630.27 / $2,630.27
| Facility | 22 | $2,630.27 | $2,630.27 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $1,513.56 / $1,513.56 / $1,513.56
| Facility | 54 | $1,513.56 | $1,513.56 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $1,380.38 / $1,380.38 / $1,380.38
| Facility | 62 | $1,380.38 | $1,380.38 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $218.78 / $218.78 / $218.78
| Facility | AS | $218.78 | $218.78 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $2,089.30 / $9,120.11
| Professional | | $1,380.38 | $2,089.30 | $9,120.11 |
- 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
- $1,513.56 / $14,125.38 / $35,481.34
| Facility | | $1,513.56 | $14,125.38 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,698.24 / $2,754.23
| Professional | | $1,174.90 | $1,698.24 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $389.05 / $389.05 / $389.05
| Professional | AS | $389.05 | $389.05 | $389.05 |