- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $114.82 / $223.87
| Facility | | $44.67 | $114.82 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $44.67 / $57.54
| Professional | | $16.98 | $44.67 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $257.04
| Facility | | $60.26 | $60.26 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $23.99 / $40.74
| Professional | | $23.44 | $23.99 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $79.43 / $117.49
| Professional | | $50.12 | $79.43 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $66.07 / $269.15
| Facility | | $38.90 | $66.07 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $29.51 / $60.26
| Professional | | $10.96 | $29.51 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $72.44 / $89.13
| Professional | | $60.26 | $72.44 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $28.18 / $33.11
| Professional | | $13.80 | $28.18 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $43.65 / $51.29
| Facility | | $16.22 | $43.65 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $16.60 / $125.89
| Professional | | $14.79 | $16.60 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $70.79 / $10,000.00
| Facility | | $26.30 | $70.79 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $70.79 / $10,000.00
| Professional | | $26.30 | $70.79 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $60.26 / $72.44
| Facility | | $14.79 | $60.26 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $25.12 / $36.31
| Professional | | $9.77 | $25.12 | $36.31 |