- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $831.76 / $1,819.70 / $5,248.07
| Facility | | $831.76 | $1,819.70 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $831.76 / $1,659.59 / $5,248.07
| Facility | 50 | $831.76 | $1,659.59 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $281.84 / $1,023.29
| Professional | | $100.00 | $281.84 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- 22
- Typical Low / Median / Typical High
- $141.25 / $141.25 / $190.55
| Professional | 22 | $141.25 | $141.25 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $151.36 / $363.08 / $2,089.30
| Professional | 50 | $151.36 | $363.08 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $37.15
| Professional | 53 | $36.31 | $36.31 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $204.17 / $416.87
| Professional | | $120.23 | $204.17 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $177.83
| Professional | | $32.36 | $33.11 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,258.93 / $1,737.80 / $2,691.53
| Facility | | $1,258.93 | $1,737.80 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,905.46 / $2,630.27 / $3,981.07
| Facility | 50 | $1,905.46 | $2,630.27 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $346.74 / $524.81
| Professional | | $177.83 | $346.74 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $371.54 / $645.65
| Professional | | $125.89 | $371.54 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $338.84 / $489.78
| Professional | | $154.88 | $338.84 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $2,818.38 / $5,128.61
| Facility | | $660.69 | $2,818.38 | $5,128.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $199.53 / $354.81
| Professional | | $100.00 | $199.53 | $354.81 |