- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,905.46 / $7,762.47 / $20,892.96
| Facility | | $1,905.46 | $7,762.47 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $3,311.31 / $4,466.84 / $10,715.19
| Facility | 22 | $3,311.31 | $4,466.84 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $4,570.88 / $9,549.93 / $26,302.68
| Facility | 50 | $4,570.88 | $9,549.93 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $89.13 / $89.13 / $1,047.13
| Facility | AS | $89.13 | $89.13 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $645.65 / $1,659.59
| Professional | | $380.19 | $645.65 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,467.37 / $9,772.37 / $20,417.38
| Facility | | $3,467.37 | $9,772.37 | $20,417.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $524.81 / $954.99
| Professional | | $363.08 | $524.81 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $1,698.24 / $10,715.19
| Facility | | $630.96 | $1,698.24 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $891.25 / $891.25 / $891.25
| Facility | 22 | $891.25 | $891.25 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $74.13 / $74.13 / $74.13
| Facility | AS | $74.13 | $74.13 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $575.44 / $1,230.27
| Professional | | $389.05 | $575.44 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,398.83 / $7,585.78 / $17,378.01
| Facility | | $2,398.83 | $7,585.78 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $537.03 / $1,047.13
| Professional | | $363.08 | $537.03 | $1,047.13 |