- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,168.69 / $10,964.78 / $24,547.09
| Facility | | $4,168.69 | $10,964.78 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $2.51 / $2.51 / $2.51
| Facility | 22 | $2.51 | $2.51 | $2.51 |
- Facility/Professional
- Facility
- Modifier
- 80
- Typical Low / Median / Typical High
- $3,715.35 / $7,079.46 / $7,079.46
| Facility | 80 | $3,715.35 | $7,079.46 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11,220.18 / $16,982.44 / $28,840.32
| Facility | | $11,220.18 | $16,982.44 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $10,471.29 / $20,417.38
| Facility | | $85.11 | $10,471.29 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $6,918.31 / $14,791.08
| Facility | | $891.25 | $6,918.31 | $14,791.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $758.58 / $1,023.29
| Professional | | $537.03 | $758.58 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $758.58 / $1,698.24
| Professional | | $630.96 | $758.58 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- 80
- Typical Low / Median / Typical High
- $117.49 / $147.91 / $501.19
| Professional | 80 | $117.49 | $147.91 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $117.49 / $117.49 / $147.91
| Professional | AS | $117.49 | $117.49 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $10,232.93 / $16,982.44
| Facility | | $7,585.78 | $10,232.93 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $13,489.63 / $13,489.63 / $13,489.63
| Facility | 52 | $13,489.63 | $13,489.63 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $1,698.24 / $1,698.24 / $1,698.24
| Facility | AS | $1,698.24 | $1,698.24 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $933.25 / $1,659.59
| Facility | | $691.83 | $933.25 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8,317.64 / $8,317.64 / $8,317.64
| Facility | | $8,317.64 | $8,317.64 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,309.57 / $13,489.63 / $28,840.32
| Facility | | $6,309.57 | $13,489.63 | $28,840.32 |