- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $5,011.87 / $5,495.41
| Facility | | $524.81 | $5,011.87 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $4,897.79 / $4,897.79 / $4,897.79
| Facility | 50 | $4,897.79 | $4,897.79 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $1,737.80 / $4,073.80
| Professional | | $199.53 | $1,737.80 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $4,897.79 / $17,782.79
| Facility | | $2,187.76 | $4,897.79 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $3,467.37 / $7,244.36 / $26,302.68
| Facility | 50 | $3,467.37 | $7,244.36 | $26,302.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $2,454.71 / $3,162.28
| Professional | | $331.13 | $2,454.71 | $3,162.28 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $489.78 / $4,570.88 / $4,677.35
| Professional | 50 | $489.78 | $4,570.88 | $4,677.35 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $44.67 / $407.38 / $426.58
| Professional | AS | $44.67 | $407.38 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $380.19 / $3,388.44
| Professional | | $223.87 | $380.19 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $1,949.84 / $5,248.07
| Facility | | $239.88 | $1,949.84 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $4,897.79 / $4,897.79 / $4,897.79
| Facility | 50 | $4,897.79 | $4,897.79 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $1,778.28 / $3,801.89
| Professional | | $208.93 | $1,778.28 | $3,801.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $77.62
| Professional | | $30.20 | $30.20 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,220.18 / $15,488.17 / $21,379.62
| Facility | | $11,220.18 | $15,488.17 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $16,982.44 / $23,988.33 / $32,359.37
| Facility | 50 | $16,982.44 | $23,988.33 | $32,359.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $380.19 / $3,311.31
| Professional | | $302.00 | $380.19 | $3,311.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $1,479.11 / $12,589.25
| Professional | | $323.59 | $1,479.11 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,332.54 / $16,982.44 / $18,197.01
| Facility | | $9,332.54 | $16,982.44 | $18,197.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $1,584.89 / $4,466.84
| Professional | | $218.78 | $1,584.89 | $4,466.84 |