- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,630.78 / $20,892.96 / $39,810.72
| Facility | | $3,630.78 | $20,892.96 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $30,199.52 / $30,199.52 / $30,199.52
| Facility | 50 | $30,199.52 | $30,199.52 | $30,199.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $1,621.81 / $4,365.16
| Professional | | $309.03 | $1,621.81 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $162.18 / $281.84 / $537.03
| Professional | AS | $162.18 | $281.84 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,348.96 / $2,630.27
| Professional | | $1,047.13 | $1,348.96 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $25,703.96 / $47,863.01
| Facility | | $9,120.11 | $25,703.96 | $47,863.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $2,290.87 / $3,235.94
| Professional | | $1,148.15 | $2,290.87 | $3,235.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,882.50 / $12,882.50 / $15,488.17
| Facility | | $12,882.50 | $12,882.50 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,819.70 / $3,311.31
| Professional | | $1,258.93 | $1,819.70 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,905.46 / $3,388.44
| Facility | | $1,318.26 | $1,905.46 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,549.93 / $22,387.21 / $48,977.88
| Facility | | $9,549.93 | $22,387.21 | $48,977.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,479.11 / $2,344.23
| Professional | | $1,122.02 | $1,479.11 | $2,344.23 |