- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $125.89 / $389.05
| Facility | | $21.88 | $125.89 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $30.20 / $61.66
| Professional | | $15.85 | $30.20 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $338.84 / $691.83
| Facility | | $239.88 | $338.84 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $28.84 / $56.23
| Professional | | $11.75 | $28.84 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $40.74 / $75.86
| Professional | | $21.38 | $40.74 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $56.23 / $275.42
| Facility | | $26.92 | $56.23 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $41.69 / $77.62
| Professional | | $26.92 | $41.69 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $32.36 / $33.11
| Professional | | $9.33 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $53.70 / $60.26
| Facility | | $36.31 | $53.70 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $38.90 / $38.90
| Facility | | $37.15 | $38.90 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $37.15 / $67.61
| Professional | | $19.95 | $37.15 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $354.81 / $691.83
| Facility | | $234.42 | $354.81 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $25.70 / $56.23
| Professional | | $11.75 | $25.70 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $489.78 / $1,047.13
| Facility | | $123.03 | $489.78 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $35.48 / $60.26
| Professional | | $19.05 | $35.48 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $31.62 / $60.26
| Professional | | $14.13 | $31.62 | $60.26 |