- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $4,677.35 / $11,748.98
| Facility | | $831.76 | $4,677.35 | $11,748.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $831.76 / $1,905.46
| Professional | | $562.34 | $831.76 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $11,220.18 / $18,620.87
| Facility | | $4,897.79 | $11,220.18 | $18,620.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $645.65 / $831.76 / $2,041.74
| Professional | | $645.65 | $831.76 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $2,398.83 / $10,964.78
| Facility | | $812.83 | $2,398.83 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $812.83 / $1,122.02
| Professional | | $812.83 | $812.83 | $1,122.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $2,290.87 / $50,118.72
| Facility | | $977.24 | $2,290.87 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $1,174.90 / $1,174.90 / $1,174.90
| Facility | 22 | $1,174.90 | $1,174.90 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $97.72 / $97.72 / $97.72
| Facility | AS | $97.72 | $97.72 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $1,071.52 / $2,818.38
| Professional | | $616.60 | $1,071.52 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $645.65 / $1,621.81
| Facility | | $398.11 | $645.65 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,122.02 / $1,698.24 / $2,344.23
| Professional | | $1,122.02 | $1,698.24 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $724.44 / $724.44
| Facility | | $724.44 | $724.44 | $724.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $977.24 / $1,659.59
| Professional | | $707.95 | $977.24 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $7,762.47 / $21,379.62
| Facility | | $3,019.95 | $7,762.47 | $21,379.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $831.76 / $1,071.52
| Professional | | $660.69 | $831.76 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $50,118.72 / $75,857.76
| Facility | | $630.96 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $1,047.13 / $2,089.30
| Professional | | $398.11 | $1,047.13 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $6,309.57 / $16,218.10
| Facility | | $2,454.71 | $6,309.57 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,047.13 / $2,630.27
| Professional | | $562.34 | $1,047.13 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $691.83 / $2,344.23
| Facility | | $478.63 | $691.83 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $933.25 / $1,819.70
| Professional | | $676.08 | $933.25 | $1,819.70 |