- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $6,165.95 / $18,620.87
| Facility | | $1,513.56 | $6,165.95 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $11,748.98 / $11,748.98 / $11,748.98
| Facility | 50 | $11,748.98 | $11,748.98 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $1,348.96 / $3,548.13
| Professional | | $588.84 | $1,348.96 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $85.11 / $165.96 / $691.83
| Professional | AS | $85.11 | $165.96 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $1,096.48 / $1,479.11
| Professional | | $173.78 | $1,096.48 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17,378.01 / $27,542.29 / $43,651.58
| Facility | | $17,378.01 | $27,542.29 | $43,651.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,548.82 / $1,737.80
| Professional | | $1,230.27 | $1,548.82 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15,135.61 / $15,135.61 / $15,135.61
| Facility | | $15,135.61 | $15,135.61 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $1,819.70 / $2,290.87
| Professional | | $331.13 | $1,819.70 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $3,981.07 / $20,417.38
| Facility | | $1,348.96 | $3,981.07 | $20,417.38 |
- 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
- $1,122.02 / $1,548.82 / $13,489.63
| Professional | | $1,122.02 | $1,548.82 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $10,715.19 / $22,387.21
| Facility | | $3,890.45 | $10,715.19 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,412.54 / $1,905.46
| Professional | | $1,096.48 | $1,412.54 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $85.11
| Professional | AS | $85.11 | $85.11 | $85.11 |