- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $22.91 / $8,511.38
| Facility | | $19.95 | $22.91 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $26.92 / $63.10
| Professional | | $19.05 | $26.92 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $31.62 / $33.11 / $52.48
| Professional | 50 | $31.62 | $33.11 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $16.60
| Professional | | $16.60 | $16.60 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3,801.89 / $10,715.19 / $11,220.18
| Facility | | $3,801.89 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $28.84 / $91.20
| Professional | | $24.55 | $28.84 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $37.15 / $43.65 / $138.04
| Professional | 50 | $37.15 | $43.65 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $24.55 / $616.60
| Facility | | $19.95 | $24.55 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $23.99 / $33.11
| Professional | | $18.62 | $23.99 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $34.67
| Facility | | $31.62 | $31.62 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $64.57 / $660.69
| Professional | | $21.88 | $64.57 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $32.36 / $33.11
| Professional | | $27.54 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $724.44 / $1,949.84
| Facility | | $50.12 | $724.44 | $1,949.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $47.86 / $75.86
| Professional | | $25.12 | $47.86 | $75.86 |