- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $8,128.31 / $18,620.87
| Facility | | $1,905.46 | $8,128.31 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $2,818.38 / $8,709.64 / $20,417.38
| Facility | 50 | $2,818.38 | $8,709.64 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $1,659.59 / $4,466.84
| Professional | | $354.81 | $1,659.59 | $4,466.84 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $162.18 / $309.03 / $891.25
| Professional | AS | $162.18 | $309.03 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $1,047.13 / $1,348.96
| Professional | | $147.91 | $1,047.13 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,344.23 / $10,964.78 / $21,379.62
| Facility | | $2,344.23 | $10,964.78 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,412.54 / $1,862.09 / $2,818.38
| Professional | | $1,412.54 | $1,862.09 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $194.98 / $263.03 / $389.05
| Professional | AS | $194.98 | $263.03 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,412.54 / $1,905.46
| Professional | | $1,202.26 | $1,412.54 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,888.44 / $12,302.69 / $14,791.08
| Facility | | $5,888.44 | $12,302.69 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,819.70 / $2,951.21
| Professional | | $1,071.52 | $1,819.70 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $2,344.23 / $33,884.42
| Facility | | $1,288.25 | $2,344.23 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- 54
- Typical Low / Median / Typical High
- $2,290.87 / $34,673.69 / $34,673.69
| Facility | 54 | $2,290.87 | $34,673.69 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $323.59 / $5,011.87 / $5,011.87
| Facility | AS | $323.59 | $5,011.87 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,949.84 / $11,220.18
| Professional | | $1,288.25 | $1,949.84 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,162.28 / $6,025.60 / $20,417.38
| Facility | | $3,162.28 | $6,025.60 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,659.59 / $2,570.40
| Professional | | $1,202.26 | $1,659.59 | $2,570.40 |