- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $186.21 / $489.78
| Facility | | $21.88 | $186.21 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $30.20 / $69.18
| Professional | | $15.85 | $30.20 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $630.96 / $2,754.23
| Facility | | $34.67 | $630.96 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $31.62 / $79.43
| Professional | | $15.85 | $31.62 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $38.90
| Facility | | $16.60 | $16.60 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $446.68
| Facility | | $50.12 | $50.12 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $38.02 / $77.62
| Professional | | $21.38 | $38.02 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $19.50 / $3,630.78
| Facility | | $14.45 | $19.50 | $3,630.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $38.02 / $56.23
| Professional | | $30.90 | $38.02 | $56.23 |
- 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
- $15.85 / $33.11 / $72.44
| Professional | | $15.85 | $33.11 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $43.65 / $151.36
| Facility | | $23.99 | $43.65 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $630.96 / $2,754.23
| Facility | | $34.67 | $630.96 | $2,754.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $31.62 / $79.43
| Professional | | $15.85 | $31.62 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $1,698.24 / $2,818.38
| Facility | | $239.88 | $1,698.24 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $33.88 / $75.86
| Professional | | $15.85 | $33.88 | $75.86 |