- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,890.45 / $14,125.38 / $28,840.32
| Facility | | $3,890.45 | $14,125.38 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $26,302.68 / $26,302.68 / $26,302.68
| Facility | 22 | $26,302.68 | $26,302.68 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $7,762.47 / $7,762.47 / $15,488.17
| Facility | 50 | $7,762.47 | $7,762.47 | $15,488.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $1,548.82 / $4,365.16
| Professional | | $831.76 | $1,548.82 | $4,365.16 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $165.96 / $346.74 / $954.99
| Professional | AS | $165.96 | $346.74 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $1,318.26 / $1,819.70
| Professional | | $234.42 | $1,318.26 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,964.78 / $15,135.61 / $19,054.61
| Facility | | $10,964.78 | $15,135.61 | $19,054.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,737.80 / $2,398.83
| Professional | | $1,348.96 | $1,737.80 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $165.96 / $194.98 / $213.80
| Professional | AS | $165.96 | $194.98 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10,471.29 / $15,848.93 / $20,892.96
| Facility | | $10,471.29 | $15,848.93 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,288.25 / $1,862.09 / $3,090.30
| Professional | | $1,288.25 | $1,862.09 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $1,258.93 / $2,630.27
| Professional | | $26.30 | $1,258.93 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $22.91 / $1,698.24
| Professional | | $22.91 | $22.91 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,148.15 / $1,148.15 / $2,344.23
| Professional | | $1,148.15 | $1,148.15 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,715.35 / $10,715.19 / $26,302.68
| Facility | | $3,715.35 | $10,715.19 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,778.28 / $3,467.37
| Professional | | $1,258.93 | $1,778.28 | $3,467.37 |