- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $3,467.37 / $10,471.29
| Facility | | $446.68 | $3,467.37 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $53,703.18 / $53,703.18 / $53,703.18
| Facility | 22 | $53,703.18 | $53,703.18 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $776.25 / $3,090.30 / $9,120.11
| Facility | 50 | $776.25 | $3,090.30 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $338.84 / $954.99
| Professional | | $234.42 | $338.84 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $218.78 / $426.58 / $1,380.38
| Professional | 50 | $218.78 | $426.58 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $8,511.38 / $19,952.62
| Facility | | $3,019.95 | $8,511.38 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $416.87 / $776.25
| Professional | | $251.19 | $416.87 | $776.25 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $371.54 / $588.84 / $1,071.52
| Professional | 50 | $371.54 | $588.84 | $1,071.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $1,862.09 / $17,782.79
| Facility | | $446.68 | $1,862.09 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $537.03 / $537.03 / $537.03
| Facility | 22 | $537.03 | $537.03 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $436.52 / $851.14
| Professional | | $275.42 | $436.52 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,737.80 / $4,786.30 / $12,022.64
| Facility | | $1,737.80 | $4,786.30 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $371.54 / $660.69
| Professional | | $239.88 | $371.54 | $660.69 |