- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $85.11 / $141.25
| Facility | | $44.67 | $85.11 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $46.77 / $85.11
| Professional | | $40.74 | $46.77 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $58.88 / $102.33
| Facility | | $51.29 | $58.88 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $34.67 / $72.44
| Professional | | $27.54 | $34.67 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $44.67
| Professional | | $44.67 | $44.67 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $37.15 / $64.57
| Facility | | $37.15 | $37.15 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Professional | | $75.86 | $75.86 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $72.44 / $229.09
| Facility | | $36.31 | $72.44 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $31.62 / $93.33
| Professional | | $25.70 | $31.62 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $213.80
| Facility | | $36.31 | $36.31 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $29.51 / $74.13
| Professional | | $25.70 | $29.51 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $50.12 / $69.18
| Professional | | $41.69 | $50.12 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $67.61 / $67.61
| Facility | | $67.61 | $67.61 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $58.88 / $114.82
| Professional | | $38.90 | $58.88 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $56.23 / $83.18
| Facility | | $29.51 | $56.23 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $33.88 / $67.61
| Professional | | $23.44 | $33.88 | $67.61 |