- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $588.84 / $2,344.23
| Facility | | $50.12 | $588.84 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $398.11 / $398.11 / $660.69
| Facility | 50 | $398.11 | $398.11 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $69.18 / $186.21
| Professional | | $30.20 | $69.18 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $41.69 / $44.67
| Professional | | $25.70 | $41.69 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $29.51 / $29.51
| Facility | | $29.51 | $29.51 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $50.12 / $70.79
| Professional | | $28.18 | $50.12 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $39.81 / $54.95
| Facility | | $29.51 | $39.81 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $100.00 / $120.23
| Professional | | $74.13 | $100.00 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $64.57 / $177.83
| Professional | | $33.88 | $64.57 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $588.84 / $4,677.35
| Facility | | $97.72 | $588.84 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $398.11 / $398.11 / $660.69
| Facility | 50 | $398.11 | $398.11 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $70.79 / $158.49
| Professional | | $35.48 | $70.79 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $58.88 / $117.49
| Professional | | $31.62 | $58.88 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $851.14 / $1,698.24
| Facility | | $316.23 | $851.14 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $63.10 / $223.87
| Professional | | $34.67 | $63.10 | $223.87 |