- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,621.81 / $3,019.95 / $14,454.40
| Facility | | $1,621.81 | $3,019.95 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $12,882.50 / $21,379.62
| Facility | | $9,120.11 | $12,882.50 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $4,466.84 / $7,079.46
| Facility | | $3,801.89 | $4,466.84 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $3,162.28 / $3,162.28 / $3,162.28
| Facility | 22 | $3,162.28 | $3,162.28 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $2,089.30 / $2,089.30 / $2,089.30
| Facility | 52 | $2,089.30 | $2,089.30 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $263.03 / $263.03 / $263.03
| Facility | AS | $263.03 | $263.03 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,041.74 / $9,332.54
| Facility | | $1,479.11 | $2,041.74 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $2,137.96 / $13,182.57
| Facility | | $1,479.11 | $2,137.96 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $5,623.41 / $5,623.41 / $5,623.41
| Facility | 52 | $5,623.41 | $5,623.41 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $691.83 / $691.83 / $691.83
| Facility | AS | $691.83 | $691.83 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,019.95 / $9,332.54 / $15,848.93
| Facility | | $3,019.95 | $9,332.54 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $3,311.31 / $5,128.61
| Professional | | $1,819.70 | $3,311.31 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $13,803.84 / $13,803.84
| Facility | | $2,630.27 | $13,803.84 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $3,162.28 / $3,162.28 / $3,162.28
| Facility | 22 | $3,162.28 | $3,162.28 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $2,089.30 / $3,019.95 / $10,964.78
| Facility | 52 | $2,089.30 | $3,019.95 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $263.03 / $380.19 / $1,380.38
| Facility | AS | $263.03 | $380.19 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5,370.32 / $5,370.32 / $5,370.32
| Professional | | $5,370.32 | $5,370.32 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,897.79 / $12,022.64 / $14,454.40
| Facility | | $4,897.79 | $12,022.64 | $14,454.40 |