- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,089.30 / $8,511.38 / $21,877.62
| Facility | | $2,089.30 | $8,511.38 | $21,877.62 |
- 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
- $588.84 / $1,995.26 / $5,248.07
| Professional | | $588.84 | $1,995.26 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $154.88 / $316.23 / $954.99
| Professional | AS | $154.88 | $316.23 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $1,096.48 / $1,230.27
| Professional | | $154.88 | $1,096.48 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $10,964.78 / $25,118.86
| Facility | | $2,344.23 | $10,964.78 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $1,862.09 / $2,754.23
| Professional | | $1,380.38 | $1,862.09 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $194.98 / $257.04 / $380.19
| Professional | AS | $194.98 | $257.04 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,412.54 / $1,905.46
| Professional | | $1,202.26 | $1,412.54 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,709.64 / $16,218.10 / $21,379.62
| Facility | | $8,709.64 | $16,218.10 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,819.70 / $2,951.21
| Professional | | $1,071.52 | $1,819.70 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $2,238.72 / $25,118.86
| Facility | | $1,230.27 | $2,238.72 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $2,290.87 / $35,481.34 / $35,481.34
| Facility | 54 | $2,290.87 | $35,481.34 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $2,041.74 / $31,622.78 / $31,622.78
| Facility | 62 | $2,041.74 | $31,622.78 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $323.59 / $5,128.61 / $5,128.61
| Facility | AS | $323.59 | $5,128.61 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,905.46 / $13,489.63
| Professional | | $1,288.25 | $1,905.46 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $281.84 / $281.84 / $281.84
| Professional | AS | $281.84 | $281.84 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $5,623.41 / $20,417.38
| Facility | | $3,162.28 | $5,623.41 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,621.81 / $2,570.40
| Professional | | $1,202.26 | $1,621.81 | $2,570.40 |