- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $1,905.46 / $3,715.35
| Facility | | $25.12 | $1,905.46 | $3,715.35 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $30.20 / $79.43
| Professional | | $12.88 | $30.20 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $199.53 / $2,818.38
| Facility | | $34.67 | $199.53 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $33.88 / $95.50
| Professional | | $14.79 | $33.88 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $38.02
| Facility | | $16.22 | $16.22 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $39.81 / $87.10
| Professional | | $18.62 | $39.81 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $33.88 / $77.62
| Professional | | $15.85 | $33.88 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $18.62 / $3,630.78
| Facility | | $14.13 | $18.62 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $44.67 / $57.54
| Professional | | $37.15 | $44.67 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $2,041.74 / $3,467.37
| Facility | | $741.31 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $33.88 / $83.18
| Professional | | $15.49 | $33.88 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $100.00 / $109.65
| Facility | | $72.44 | $100.00 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $199.53 / $2,818.38
| Facility | | $34.67 | $199.53 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $33.88 / $95.50
| Professional | | $14.79 | $33.88 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $1,698.24 / $2,818.38
| Facility | | $154.88 | $1,698.24 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $33.88 / $79.43
| Professional | | $15.85 | $33.88 | $79.43 |