- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $51.29 / $75.86
| Facility | | $22.91 | $51.29 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $20.89 / $38.90
| Professional | | $14.13 | $20.89 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $26.92 / $70.79
| Facility | | $26.92 | $26.92 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $46.77
| Professional | | $10.96 | $10.96 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $26.92 / $26.92
| Facility | | $16.22 | $26.92 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $26.92 / $26.92
| Professional | | $19.95 | $26.92 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $57.54 / $70.79
| Facility | | $26.30 | $57.54 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $87.10 / $131.83
| Professional | | $16.22 | $87.10 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $34.67 / $74.13
| Facility | | $21.88 | $34.67 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $19.05 / $52.48
| Professional | | $10.96 | $19.05 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $10.72
| Facility | | $10.72 | $10.72 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $21.38 / $29.51
| Professional | | $10.72 | $21.38 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $93.33 / $93.33
| Facility | | $93.33 | $93.33 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $51.29 / $50,118.72
| Facility | | $26.92 | $51.29 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $26.92 / $36.31
| Facility | | $17.78 | $26.92 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $16.22 / $61.66
| Professional | | $11.48 | $16.22 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $12.59 / $32.36
| Facility | | $10.72 | $12.59 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $22.91 / $33.11
| Professional | | $10.72 | $22.91 | $33.11 |