- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $12,022.64 / $27,542.29
| Facility | | $3,019.95 | $12,022.64 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $3,890.45 / $3,890.45 / $9,332.54
| Facility | 22 | $3,890.45 | $3,890.45 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $4,897.79 / $16,595.87 / $38,018.94
| Facility | 50 | $4,897.79 | $16,595.87 | $38,018.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,737.80 / $3,715.35
| Professional | | $1,071.52 | $1,737.80 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $169.82 / $323.59 / $588.84
| Professional | AS | $169.82 | $323.59 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $1,122.02 / $1,621.81
| Professional | | $158.49 | $1,122.02 | $1,621.81 |
- 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
- $2,137.96 / $23,442.29 / $37,153.52
| Facility | | $2,137.96 | $23,442.29 | $37,153.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $1,862.09 / $3,090.30
| Professional | | $1,348.96 | $1,862.09 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $190.55 / $263.03 / $426.58
| Professional | AS | $190.55 | $263.03 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,318.26 / $1,584.89 / $1,778.28
| Professional | | $1,318.26 | $1,584.89 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $1,584.89 / $2,089.30
| Facility | | $1,230.27 | $1,584.89 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,621.81 / $2,884.03
| Professional | | $1,258.93 | $1,621.81 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $21,379.62 / $23,988.33
| Facility | | $1,778.28 | $21,379.62 | $23,988.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,862.09 / $2,691.53
| Professional | | $1,202.26 | $1,862.09 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $11,220.18 / $21,379.62
| Facility | | $6,309.57 | $11,220.18 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,071.52 / $1,737.80 / $2,630.27
| Professional | | $1,071.52 | $1,737.80 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $66.07 / $93.33 / $177.83
| Professional | AS | $66.07 | $93.33 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $309.03
| Professional | | $32.36 | $33.11 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $15,848.93
| Facility | | $100.00 | $100.00 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,548.82 / $2,398.83
| Professional | | $1,174.90 | $1,548.82 | $2,398.83 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $257.04 / $331.13 / $398.11
| Professional | AS | $257.04 | $331.13 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $12,589.25 / $29,512.09
| Facility | | $6,918.31 | $12,589.25 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,584.89 / $2,454.71
| Professional | | $1,023.29 | $1,584.89 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $407.38 / $457.09 / $457.09
| Professional | AS | $407.38 | $457.09 | $457.09 |