- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $12,022.64 / $19,952.62
| Facility | | $4,897.79 | $12,022.64 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,778.28 / $6,165.95
| Professional | | $1,148.15 | $1,778.28 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $162.18 / $331.13 / $1,230.27
| Professional | AS | $162.18 | $331.13 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,128.31 / $25,118.86 / $58,884.37
| Facility | | $8,128.31 | $25,118.86 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $30,199.52 / $52,480.75 / $138,038.43
| Facility | 50 | $30,199.52 | $52,480.75 | $138,038.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $4,073.80 / $4,073.80
| Professional | | $4,073.80 | $4,073.80 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,235.94 / $4,570.88 / $10,964.78
| Facility | | $3,235.94 | $4,570.88 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $3,715.35 / $5,623.41
| Professional | | $2,238.72 | $3,715.35 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $4,365.16 / $8,709.64
| Facility | | $3,548.13 | $4,365.16 | $8,709.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $3,090.30 / $4,897.79
| Professional | | $2,187.76 | $3,090.30 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $7,762.47 / $16,218.10
| Facility | | $1,995.26 | $7,762.47 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $8,317.64 / $8,317.64 / $8,317.64
| Facility | 22 | $8,317.64 | $8,317.64 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $16,218.10 / $17,782.79 / $20,417.38
| Facility | 50 | $16,218.10 | $17,782.79 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $2,290.87 / $2,290.87 / $2,290.87
| Facility | 54 | $2,290.87 | $2,290.87 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $323.59 / $323.59 / $323.59
| Facility | AS | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,698.24 / $3,467.37 / $10,964.78
| Professional | | $1,698.24 | $3,467.37 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $295.12 / $295.12 / $446.68
| Professional | AS | $295.12 | $295.12 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,584.89 / $11,220.18 / $33,113.11
| Facility | | $1,584.89 | $11,220.18 | $33,113.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $2,754.23 / $5,370.32
| Professional | | $1,412.54 | $2,754.23 | $5,370.32 |