- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $64.57 / $457.09
| Facility | | $28.18 | $64.57 | $457.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $28.84 / $63.10
| Professional | | $16.98 | $28.84 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $39.81 / $87.10 / $102.33
| Professional | 50 | $39.81 | $87.10 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $48.98 / $56.23
| Professional | | $16.60 | $48.98 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $2,344.23 / $4,168.69
| Facility | | $758.58 | $2,344.23 | $4,168.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $38.02 / $60.26
| Professional | | $22.39 | $38.02 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $33.88 / $57.54 / $89.13
| Professional | 50 | $33.88 | $57.54 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $24.55 / $33.88
| Facility | | $20.42 | $24.55 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $33.11 / $38.90
| Professional | | $25.70 | $33.11 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $2,511.89 / $2,511.89
| Facility | | $2,511.89 | $2,511.89 | $2,511.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $39.81 / $69.18
| Professional | | $22.39 | $39.81 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $31.62 / $74.13
| Professional | | $17.38 | $31.62 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $42.66 / $47.86
| Professional | | $26.30 | $42.66 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $213.80 / $1,318.26 / $2,344.23
| Facility | | $213.80 | $1,318.26 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $34.67 / $61.66
| Professional | | $18.62 | $34.67 | $61.66 |