- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,230.27 / $4,466.84 / $12,882.50
| Facility | | $1,230.27 | $4,466.84 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $4,073.80 / $7,244.36 / $22,387.21
| Facility | 50 | $4,073.80 | $7,244.36 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,248.07 / $9,120.11 / $18,197.01
| Facility | | $5,248.07 | $9,120.11 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $3,090.30 / $14,125.38
| Facility | | $1,000.00 | $3,090.30 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $7,585.78 / $7,585.78
| Facility | | $870.96 | $7,585.78 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,548.82 / $3,630.78 / $6,918.31
| Facility | | $1,548.82 | $3,630.78 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $1,862.09 / $1,862.09 / $1,862.09
| Facility | 22 | $1,862.09 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $154.88 / $154.88 / $154.88
| Facility | AS | $154.88 | $154.88 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,456.54 / $30,199.52 / $30,199.52
| Facility | | $6,456.54 | $30,199.52 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $2,089.30 / $2,089.30 / $2,089.30
| Facility | AS | $2,089.30 | $2,089.30 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $933.25 / $1,698.24 / $8,511.38
| Facility | | $933.25 | $1,698.24 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,995.26 / $7,244.36 / $17,782.79
| Facility | 50 | $1,995.26 | $7,244.36 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,202.26 / $2,290.87
| Facility | | $891.25 | $1,202.26 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $1,862.09 / $1,862.09 / $1,862.09
| Facility | 22 | $1,862.09 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $154.88 / $154.88 / $154.88
| Facility | AS | $154.88 | $154.88 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,754.23 / $7,413.10 / $14,454.40
| Facility | | $2,754.23 | $7,413.10 | $14,454.40 |