- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $6,456.54 / $21,877.62
| Facility | | $2,398.83 | $6,456.54 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $20,892.96 / $20,892.96 / $20,892.96
| Facility | 22 | $20,892.96 | $20,892.96 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $35,481.34 / $35,481.34 / $35,481.34
| Facility | 50 | $35,481.34 | $35,481.34 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,778.28 / $4,570.88
| Professional | | $1,071.52 | $1,778.28 | $4,570.88 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $162.18 / $380.19 / $933.25
| Professional | AS | $162.18 | $380.19 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $1,445.44 / $2,290.87
| Professional | | $223.87 | $1,445.44 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $8,128.31 / $13,489.63
| Facility | | $2,454.71 | $8,128.31 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $2,398.83 / $26,915.35
| Professional | | $1,513.56 | $2,398.83 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $30.20
| Facility | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,862.09 / $2,818.38
| Professional | | $1,288.25 | $1,862.09 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20,892.96 / $53,703.18 / $53,703.18
| Facility | | $20,892.96 | $53,703.18 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $38,018.94 / $38,018.94 / $38,018.94
| Facility | 54 | $38,018.94 | $38,018.94 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $33,884.42 / $33,884.42 / $33,884.42
| Facility | 62 | $33,884.42 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $5,370.32 / $5,370.32 / $5,370.32
| Facility | AS | $5,370.32 | $5,370.32 | $5,370.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14,125.38 / $14,125.38 / $14,125.38
| Professional | | $14,125.38 | $14,125.38 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $12,589.25 / $26,915.35
| Facility | | $6,456.54 | $12,589.25 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,659.59 / $2,754.23
| Professional | | $1,148.15 | $1,659.59 | $2,754.23 |