- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $8,128.31 / $16,595.87
| Facility | | $1,778.28 | $8,128.31 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $3,890.45 / $3,890.45 / $3,890.45
| Facility | 22 | $3,890.45 | $3,890.45 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $8,317.64 / $8,317.64 / $16,982.44
| Facility | 50 | $8,317.64 | $8,317.64 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,621.81 / $3,162.28
| Professional | | $1,071.52 | $1,621.81 | $3,162.28 |
- 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
- $147.91 / $1,096.48 / $1,548.82
| Professional | | $147.91 | $1,096.48 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $302.00 / $302.00 / $302.00
| Professional | AS | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $30,902.95 / $34,673.69
| Facility | | $5,888.44 | $30,902.95 | $34,673.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,548.82 / $2,290.87
| Professional | | $1,258.93 | $1,548.82 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $177.83 / $213.80 / $323.59
| Professional | AS | $177.83 | $213.80 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,548.82 / $2,041.74
| Facility | | $1,202.26 | $1,548.82 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,479.11 / $1,905.46
| Professional | | $1,230.27 | $1,479.11 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $2,187.76 / $2,187.76
| Facility | | $34.67 | $2,187.76 | $2,187.76 |
- 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
- $1,380.38 / $2,187.76 / $9,549.93
| Professional | | $1,380.38 | $2,187.76 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,445.44
| Professional | | $32.36 | $33.11 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,513.56 / $14,125.38 / $35,481.34
| Facility | | $1,513.56 | $14,125.38 | $35,481.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,778.28 / $2,818.38
| Professional | | $1,174.90 | $1,778.28 | $2,818.38 |