- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $8,511.38 / $15,488.17
| Facility | | $3,090.30 | $8,511.38 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $6,606.93 / $9,549.93 / $22,908.68
| Facility | 50 | $6,606.93 | $9,549.93 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $389.05 / $645.65 / $1,659.59
| Professional | | $389.05 | $645.65 | $1,659.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $575.44 / $812.83
| Professional | | $407.38 | $575.44 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $1,949.84 / $3,235.94
| Facility | | $1,949.84 | $1,949.84 | $3,235.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $457.09 / $616.60 / $1,258.93
| Professional | | $457.09 | $616.60 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $3,311.31 / $5,495.41
| Facility | | $501.19 | $3,311.31 | $5,495.41 |
- 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
- $436.52 / $602.56 / $1,047.13
| Professional | | $436.52 | $602.56 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $676.08 / $676.08
| Professional | | $676.08 | $676.08 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $537.03 / $870.96
| Facility | | $416.87 | $537.03 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $501.19 / $1,148.15
| Professional | | $501.19 | $501.19 | $1,148.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,218.10 / $16,218.10 / $16,218.10
| Facility | | $16,218.10 | $16,218.10 | $16,218.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $489.78 / $616.60 / $676.08
| Professional | | $489.78 | $616.60 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,819.70 / $10,232.93 / $22,908.68
| Facility | | $1,819.70 | $10,232.93 | $22,908.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $467.74 / $831.76
| Professional | | $354.81 | $467.74 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,982.44 / $16,982.44 / $33,884.42
| Facility | | $16,982.44 | $16,982.44 | $33,884.42 |
- 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
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4,073.80 / $4,073.80 / $4,073.80
| Professional | | $4,073.80 | $4,073.80 | $4,073.80 |