- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $6,918.31 / $25,118.86
| Facility | | $1,096.48 | $6,918.31 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $7,943.28 / $8,317.64 / $8,912.51
| Facility | 22 | $7,943.28 | $8,317.64 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $8,317.64 / $8,317.64 / $8,317.64
| Facility | 52 | $8,317.64 | $8,317.64 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- 80
- Typical Low / Median / Typical High
- $954.99 / $954.99 / $1,096.48
| Facility | 80 | $954.99 | $954.99 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,466.84 / $8,317.64 / $18,620.87
| Facility | | $4,466.84 | $8,317.64 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $2,754.23 / $10,964.78
| Facility | | $1,023.29 | $2,754.23 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $25,703.96 / $30,902.95
| Facility | | $1,230.27 | $25,703.96 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $1,479.11 / $1,479.11 / $1,479.11
| Facility | 22 | $1,479.11 | $1,479.11 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $977.24 / $977.24 / $977.24
| Facility | 52 | $977.24 | $977.24 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $123.03 / $123.03 / $123.03
| Facility | AS | $123.03 | $123.03 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $794.33 / $1,071.52 / $3,801.89
| Facility | | $794.33 | $1,071.52 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $660.69 / $660.69
| Facility | | $660.69 | $660.69 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4,786.30 / $10,000.00 / $18,620.87
| Facility | | $4,786.30 | $10,000.00 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $50,118.72 / $75,857.76
| Facility | | $741.31 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $6,309.57 / $15,135.61
| Facility | | $2,398.83 | $6,309.57 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $851.14 / $2,884.03
| Facility | | $575.44 | $851.14 | $2,884.03 |