- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,659.59 / $14,791.08 / $46,773.51
| Facility | | $1,659.59 | $14,791.08 | $46,773.51 |
- 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
- $4,073.80 / $4,073.80 / $4,073.80
| Facility | 53 | $4,073.80 | $4,073.80 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,258.93 / $2,630.27
| Professional | | $891.25 | $1,258.93 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $954.99 / $1,513.56
| Professional | | $812.83 | $954.99 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $21,379.62 / $40,738.03
| Facility | | $1,174.90 | $21,379.62 | $40,738.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $691.83 / $912.01 / $1,230.27
| Professional | | $691.83 | $912.01 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $16,595.87 / $47,863.01
| Facility | | $398.11 | $16,595.87 | $47,863.01 |
- 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
- $891.25 / $1,479.11 / $2,511.89
| Professional | | $891.25 | $1,479.11 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16,982.44 / $26,302.68 / $48,977.88
| Facility | | $16,982.44 | $26,302.68 | $48,977.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $602.56 / $645.65 / $1,096.48
| Professional | | $602.56 | $645.65 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $1,174.90
| Professional | | $32.36 | $33.11 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $19,054.61 / $41,686.94
| Facility | | $7,762.47 | $19,054.61 | $41,686.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,479.11 / $2,630.27
| Professional | | $1,000.00 | $1,479.11 | $2,630.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $707.95 / $707.95 / $1,174.90
| Professional | | $707.95 | $707.95 | $1,174.90 |