- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $9,549.93 / $19,498.45
| Facility | | $3,801.89 | $9,549.93 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $7,079.46 / $11,220.18 / $21,877.62
| Facility | 50 | $7,079.46 | $11,220.18 | $21,877.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $630.96 / $1,318.26
| Professional | | $407.38 | $630.96 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $537.03 / $794.33
| Professional | | $380.19 | $537.03 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $3,630.78 / $9,772.37
| Facility | | $933.25 | $3,630.78 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $724.44 / $1,174.90
| Professional | | $457.09 | $724.44 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $602.56 / $794.33
| Facility | | $501.19 | $602.56 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $524.81 / $660.69
| Professional | | $398.11 | $524.81 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $3,715.35 / $9,772.37
| Facility | | $616.60 | $3,715.35 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $602.56 / $1,000.00
| Professional | | $416.87 | $602.56 | $1,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $575.44 / $1,148.15
| Professional | | $436.52 | $575.44 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- 22
- Typical Low / Median / Typical High
- $1,230.27 / $1,230.27 / $1,548.82
| Professional | 22 | $1,230.27 | $1,230.27 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- 80
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $41.69
| Professional | 80 | $32.36 | $32.36 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- AS
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $20.89
| Professional | AS | $16.22 | $16.22 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $9,772.37 / $14,125.38
| Facility | | $6,456.54 | $9,772.37 | $14,125.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $812.83 / $1,047.13
| Professional | | $436.52 | $812.83 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $6,309.57 / $14,454.40
| Facility | | $870.96 | $6,309.57 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $524.81 / $933.25
| Professional | | $389.05 | $524.81 | $933.25 |