- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $12,589.25 / $30,902.95
| Facility | | $3,162.28 | $12,589.25 | $30,902.95 |
- 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
- $12,882.50 / $12,882.50 / $12,882.50
| Facility | 50 | $12,882.50 | $12,882.50 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,905.46 / $5,128.61
| Professional | | $1,122.02 | $1,905.46 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $162.18 / $316.23 / $691.83
| Professional | AS | $162.18 | $316.23 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $1,071.52 / $1,621.81
| Professional | | $154.88 | $1,071.52 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $22,908.68 / $33,884.42
| Facility | | $3,235.94 | $22,908.68 | $33,884.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,659.59 / $2,630.27
| Professional | | $1,258.93 | $1,659.59 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $177.83 / $234.42 / $363.08
| Professional | AS | $177.83 | $234.42 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,380.38 / $1,778.28
| Professional | | $1,148.15 | $1,380.38 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,584.89 / $2,089.30
| Facility | | $1,230.27 | $1,584.89 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,621.81 / $2,951.21
| Professional | | $1,258.93 | $1,621.81 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21,379.62 / $25,703.96 / $25,703.96
| Facility | | $21,379.62 | $25,703.96 | $25,703.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,778.28 / $2,630.27
| Professional | | $1,202.26 | $1,778.28 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $12,022.64 / $25,118.86
| Facility | | $6,456.54 | $12,022.64 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,737.80 / $2,570.40
| Professional | | $1,096.48 | $1,737.80 | $2,570.40 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $52.48 / $181.97 / $295.12
| Professional | AS | $52.48 | $181.97 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $288.40
| Professional | | $32.36 | $33.11 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $15,848.93
| Facility | | $100.00 | $100.00 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,548.82 / $2,630.27
| Professional | | $1,174.90 | $1,548.82 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $316.23 / $331.13 / $398.11
| Professional | AS | $316.23 | $331.13 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $12,589.25 / $29,512.09
| Facility | | $6,918.31 | $12,589.25 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,548.82 / $2,454.71
| Professional | | $1,000.00 | $1,548.82 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $389.05 / $436.52 / $660.69
| Professional | AS | $389.05 | $436.52 | $660.69 |