- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,365.16 / $10,964.78 / $25,118.86
| Facility | | $4,365.16 | $10,964.78 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $15,135.61 / $15,135.61 / $15,135.61
| Facility | 22 | $15,135.61 | $15,135.61 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $17,782.79 / $17,782.79 / $66,069.34
| Facility | 50 | $17,782.79 | $17,782.79 | $66,069.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $1,548.82 / $3,630.78
| Professional | | $645.65 | $1,548.82 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $158.49 / $323.59 / $616.60
| Professional | AS | $158.49 | $323.59 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $1,479.11 / $2,290.87
| Professional | | $204.17 | $1,479.11 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $295.12 / $295.12 / $295.12
| Professional | AS | $295.12 | $295.12 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $7,413.10 / $28,840.32
| Facility | | $2,344.23 | $7,413.10 | $28,840.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,344.23 / $3,162.28
| Professional | | $1,479.11 | $2,344.23 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $213.80 / $323.59 / $446.68
| Professional | AS | $213.80 | $323.59 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $1,778.28 / $2,511.89
| Facility | | $1,513.56 | $1,778.28 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,513.56 / $1,778.28
| Professional | | $1,174.90 | $1,513.56 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15,848.93 / $15,848.93 / $53,703.18
| Facility | | $15,848.93 | $15,848.93 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $2,187.76 / $3,548.13
| Professional | | $1,412.54 | $2,187.76 | $3,548.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,905.46 / $5,495.41
| Professional | | $1,318.26 | $1,905.46 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- 22
- Typical Low / Median / Typical High
- $3,801.89 / $3,801.89 / $3,801.89
| Professional | 22 | $3,801.89 | $3,801.89 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- 54
- Typical Low / Median / Typical High
- $1,778.28 / $1,778.28 / $1,778.28
| Professional | 54 | $1,778.28 | $1,778.28 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- 80
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Professional | 80 | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $50.12
| Professional | AS | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $2,238.72 / $2,238.72
| Professional | | $1,995.26 | $2,238.72 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $9,120.11 / $25,118.86
| Facility | | $2,884.03 | $9,120.11 | $25,118.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,949.84 / $3,090.30
| Professional | | $1,202.26 | $1,949.84 | $3,090.30 |