- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $3,801.89 / $8,709.64
| Facility | | $524.81 | $3,801.89 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $3,981.07 / $3,981.07 / $3,981.07
| Facility | 22 | $3,981.07 | $3,981.07 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $9,549.93 / $14,454.40 / $14,454.40
| Facility | 50 | $9,549.93 | $14,454.40 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $537.03 / $1,412.54
| Professional | | $380.19 | $537.03 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $724.44 / $1,318.26 / $1,905.46
| Professional | 50 | $724.44 | $1,318.26 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $234.42 / $912.01
| Professional | | $208.93 | $234.42 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,630.27 / $4,786.30 / $9,549.93
| Facility | | $2,630.27 | $4,786.30 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $416.87 / $1,202.26
| Professional | | $331.13 | $416.87 | $1,202.26 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $478.63 / $602.56 / $1,778.28
| Professional | 50 | $478.63 | $602.56 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $1,698.24 / $6,165.95
| Facility | | $616.60 | $1,698.24 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $616.60 / $630.96
| Professional | | $616.60 | $616.60 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $1,659.59 / $50,118.72
| Facility | | $741.31 | $1,659.59 | $50,118.72 |
- 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
- Professional
- Modifier
- Typical Low / Median / Typical High
- $416.87 / $660.69 / $2,041.74
| Professional | | $416.87 | $660.69 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $501.19 / $1,148.15 / $1,949.84
| Facility | | $501.19 | $1,148.15 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $524.81 / $794.33 / $1,288.25
| Professional | | $524.81 | $794.33 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $426.58 / $426.58
| Facility | | $426.58 | $426.58 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $870.96 / $1,202.26
| Professional | | $363.08 | $870.96 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $2,041.74 / $5,128.61
| Facility | | $1,096.48 | $2,041.74 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $1,995.26 / $1,995.26 / $1,995.26
| Facility | 50 | $1,995.26 | $1,995.26 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $616.60 / $2,691.53
| Professional | | $426.58 | $616.60 | $2,691.53 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $933.25 / $933.25 / $933.25
| Professional | 50 | $933.25 | $933.25 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $426.58 / $50,118.72 / $75,857.76
| Facility | | $426.58 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $602.56 / $1,000.00
| Professional | | $398.11 | $602.56 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,137.96 / $3,981.07 / $8,317.64
| Facility | | $2,137.96 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $676.08 / $1,949.84
| Professional | | $398.11 | $676.08 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $512.86 / $1,819.70
| Facility | | $363.08 | $512.86 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $691.83 / $1,380.38
| Professional | | $363.08 | $691.83 | $1,380.38 |