- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $12,589.25 / $28,840.32
| Facility | | $3,801.89 | $12,589.25 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $8,317.64 / $17,378.01 / $29,512.09
| Facility | 50 | $8,317.64 | $17,378.01 | $29,512.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $724.44 / $2,511.89
| Professional | | $398.11 | $724.44 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9,120.11 / $12,882.50 / $22,387.21
| Facility | | $9,120.11 | $12,882.50 | $22,387.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $794.33 / $2,041.74
| Professional | | $407.38 | $794.33 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $537.03 / $851.14
| Facility | | $416.87 | $537.03 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $478.63 / $1,000.00
| Professional | | $398.11 | $478.63 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,288.25 / $5,623.41
| Facility | | $1,096.48 | $1,288.25 | $5,623.41 |
- 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
- $446.68 / $1,047.13 / $1,778.28
| Professional | | $446.68 | $1,047.13 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $630.96 / $8,912.51
| Facility | | $416.87 | $630.96 | $8,912.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $912.01 / $1,412.54
| Professional | | $741.31 | $912.01 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $912.01 / $15,135.61
| Facility | | $426.58 | $912.01 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $4,677.35 / $10,000.00 / $12,589.25
| Facility | 50 | $4,677.35 | $10,000.00 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $1,548.82 / $1,548.82 / $1,548.82
| Facility | AS | $1,548.82 | $1,548.82 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $776.25 / $3,981.07
| Professional | | $436.52 | $776.25 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $851.14 / $10,715.19 / $17,378.01
| Facility | | $851.14 | $10,715.19 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $933.25 / $1,621.81
| Professional | | $467.74 | $933.25 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $1,000.00 / $1,548.82
| Professional | | $549.54 | $1,000.00 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $16,218.10 / $16,218.10
| Facility | | $741.31 | $16,218.10 | $16,218.10 |
- 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 / $1,096.48 / $1,621.81
| Facility | AS | $74.13 | $1,096.48 | $1,621.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $2,041.74 / $3,981.07
| Professional | | $446.68 | $2,041.74 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $1,548.82 / $1,548.82
| Professional | | $1,548.82 | $1,548.82 | $1,548.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,479.11 / $1,737.80 / $2,089.30
| Professional | | $1,479.11 | $1,737.80 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,918.31 / $13,803.84 / $17,378.01
| Facility | | $6,918.31 | $13,803.84 | $17,378.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $338.84 / $630.96 / $1,995.26
| Professional | | $338.84 | $630.96 | $1,995.26 |