- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $81.28 / $162.18
| Facility | | $28.84 | $81.28 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $15.14 / $104.71
| Professional | | $10.96 | $15.14 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $37.15 / $79.43
| Facility | | $8.32 | $37.15 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $12.88 / $41.69
| Professional | | $7.24 | $12.88 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $89.13 / $229.09
| Facility | | $35.48 | $89.13 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $16.60 / $47.86
| Professional | | $11.48 | $16.60 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $27.54 / $57.54
| Facility | | $12.02 | $27.54 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $17.38 / $36.31
| Professional | | $8.71 | $17.38 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.85 / $25.12
| Professional | | $12.88 | $15.85 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $15.85 / $35.48
| Professional | | $12.59 | $15.85 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $9.55 / $19.05
| Professional | | $9.55 | $9.55 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $19.05 / $46.77
| Facility | | $12.59 | $19.05 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $13.80 / $36.31
| Professional | | $8.71 | $13.80 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $54.95
| Professional | | $54.95 | $54.95 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $14.45 / $21.88
| Professional | | $12.59 | $14.45 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.72 / $15.85
| Facility | | $7.08 | $10.72 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $9.55 / $30.90
| Professional | | $6.61 | $9.55 | $30.90 |