- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $9,772.37 / $26,915.35
| Facility | | $1,698.24 | $9,772.37 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $15,848.93 / $27,542.29 / $79,432.82
| Facility | 50 | $15,848.93 | $27,542.29 | $79,432.82 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $16,982.44 / $16,982.44 / $31,622.78
| Facility | AS | $16,982.44 | $16,982.44 | $31,622.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,995.26 / $8,709.64
| Professional | | $1,071.52 | $1,995.26 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $162.18 / $295.12 / $660.69
| Professional | AS | $162.18 | $295.12 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $1,000.00 / $1,737.80
| Professional | | $158.49 | $1,000.00 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $138.04 / $302.00 / $323.59
| Professional | AS | $138.04 | $302.00 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21,877.62 / $38,904.51 / $57,543.99
| Facility | | $21,877.62 | $38,904.51 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,089.30 / $3,388.44
| Professional | | $1,479.11 | $2,089.30 | $3,388.44 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $208.93 / $295.12 / $478.63
| Professional | AS | $208.93 | $295.12 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,445.44 / $1,659.59
| Facility | | $1,174.90 | $1,445.44 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,479.11 / $1,659.59
| Professional | | $1,174.90 | $1,479.11 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $2,344.23 / $3,890.45
| Facility | | $1,412.54 | $2,344.23 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,737.80 / $3,162.28
| Professional | | $1,148.15 | $1,737.80 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,165.95 / $13,803.84 / $24,547.09
| Facility | | $6,165.95 | $13,803.84 | $24,547.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,584.89 / $2,754.23
| Professional | | $1,122.02 | $1,584.89 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $302.00 / $302.00 / $302.00
| Professional | AS | $302.00 | $302.00 | $302.00 |