- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,388.44 / $6,309.57 / $14,454.40
| Facility | | $3,388.44 | $6,309.57 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $10,964.78 / $19,054.61
| Facility | | $6,606.93 | $10,964.78 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $9,120.11 / $14,454.40
| Facility | | $7,762.47 | $9,120.11 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $3,467.37 / $3,467.37 / $3,467.37
| Facility | 62 | $3,467.37 | $3,467.37 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,884.03 / $3,981.07 / $9,332.54
| Facility | | $2,884.03 | $3,981.07 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $3,715.35 / $7,943.28
| Facility | | $2,630.27 | $3,715.35 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $9,120.11 / $9,120.11 / $9,120.11
| Facility | 62 | $9,120.11 | $9,120.11 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,570.88 / $4,570.88 / $4,786.30
| Facility | | $4,570.88 | $4,570.88 | $4,786.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $7,079.46 / $10,964.78
| Professional | | $3,981.07 | $7,079.46 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,495.41 / $57,543.99 / $57,543.99
| Facility | | $5,495.41 | $57,543.99 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $3,467.37 / $4,897.79 / $36,307.81
| Facility | 62 | $3,467.37 | $4,897.79 | $36,307.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11,220.18 / $11,220.18 / $11,220.18
| Professional | | $11,220.18 | $11,220.18 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,290.87 / $6,760.83 / $19,498.45
| Facility | | $2,290.87 | $6,760.83 | $19,498.45 |