- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,778.28 / $4,897.79 / $12,022.64
| Facility | | $1,778.28 | $4,897.79 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $2,884.03 / $5,248.07
| Professional | | $251.19 | $2,884.03 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $416.87 / $6,760.83 / $11,481.54
| Professional | 50 | $416.87 | $6,760.83 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,238.72 / $4,677.35 / $10,000.00
| Facility | | $2,238.72 | $4,677.35 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $1,071.52 / $5,248.07
| Professional | | $245.47 | $1,071.52 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $371.54 / $1,584.89 / $7,943.28
| Professional | 50 | $371.54 | $1,584.89 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $34.67 / $147.91 / $741.31
| Professional | AS | $34.67 | $147.91 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $2,754.23 / $4,466.84
| Professional | | $223.87 | $2,754.23 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,481.54 / $13,182.57 / $17,782.79
| Facility | | $11,481.54 | $13,182.57 | $17,782.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $269.15 / $562.34 / $6,918.31
| Professional | | $269.15 | $562.34 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $3,235.94 / $6,918.31
| Facility | | $288.40 | $3,235.94 | $6,918.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,548.13 / $5,495.41 / $22,908.68
| Professional | | $3,548.13 | $5,495.41 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,090.30 / $6,025.60
| Facility | | $2,137.96 | $3,090.30 | $6,025.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $2,884.03 / $5,623.41
| Professional | | $275.42 | $2,884.03 | $5,623.41 |