- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $12,882.50 / $51,286.14
| Facility | | $1,862.09 | $12,882.50 | $51,286.14 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $32,359.37 / $32,359.37 / $33,113.11
| Facility | 22 | $32,359.37 | $32,359.37 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $2,818.38 / $2,818.38 / $4,073.80
| Facility | 53 | $2,818.38 | $2,818.38 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $1,288.25 / $4,073.80
| Professional | | $870.96 | $1,288.25 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,079.46 / $19,054.61 / $48,977.88
| Facility | | $7,079.46 | $19,054.61 | $48,977.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,479.11 / $2,951.21
| Professional | | $1,023.29 | $1,479.11 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $19,498.45 / $52,480.75
| Facility | | $1,995.26 | $19,498.45 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $1,819.70 / $1,819.70 / $1,819.70
| Facility | 22 | $1,819.70 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $302.00 / $302.00 / $302.00
| Facility | 53 | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,698.24 / $3,162.28
| Professional | | $1,096.48 | $1,698.24 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,981.07 / $14,791.08 / $45,708.82
| Facility | | $3,981.07 | $14,791.08 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,513.56 / $2,754.23
| Professional | | $1,000.00 | $1,513.56 | $2,754.23 |