- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $9,120.11 / $33,884.42
| Facility | | $1,905.46 | $9,120.11 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $9,549.93 / $39,810.72 / $53,703.18
| Facility | 50 | $9,549.93 | $39,810.72 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $1,698.24 / $4,265.80
| Professional | | $512.86 | $1,698.24 | $4,265.80 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $162.18 / $331.13 / $691.83
| Professional | AS | $162.18 | $331.13 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,982.44 / $35,481.34 / $66,069.34
| Facility | | $16,982.44 | $35,481.34 | $66,069.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,778.28 / $2,884.03
| Professional | | $1,348.96 | $1,778.28 | $2,884.03 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $165.96 / $208.93 / $426.58
| Professional | AS | $165.96 | $208.93 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $13,182.57 / $41,686.94
| Facility | | $2,187.76 | $13,182.57 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $2,630.27 / $2,630.27 / $2,630.27
| Facility | 22 | $2,630.27 | $2,630.27 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $1,513.56 / $1,513.56 / $1,513.56
| Facility | 54 | $1,513.56 | $1,513.56 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $218.78 / $218.78 / $218.78
| Facility | AS | $218.78 | $218.78 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,905.46 / $3,548.13
| Professional | | $1,412.54 | $1,905.46 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,819.70 / $4,677.35
| Professional | | $1,174.90 | $1,819.70 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,174.90 / $2,454.71
| Professional | | $1,174.90 | $1,174.90 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12,302.69 / $26,302.68 / $40,738.03
| Facility | | $12,302.69 | $26,302.68 | $40,738.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,041.74 / $3,235.94
| Professional | | $1,479.11 | $2,041.74 | $3,235.94 |