- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $114.82 / $186.21
| Facility | | $40.74 | $114.82 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $40.74 / $117.49
| Professional | | $33.11 | $40.74 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $61.66 / $380.19
| Facility | | $39.81 | $61.66 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $43.65 / $107.15
| Professional | | $26.30 | $43.65 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $107.15 / $154.88
| Facility | | $87.10 | $107.15 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $41.69 / $56.23
| Professional | | $41.69 | $41.69 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $69.18 / $169.82
| Facility | | $34.67 | $69.18 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $50.12 / $114.82
| Professional | | $26.92 | $50.12 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $346.74 / $7,079.46
| Facility | | $50.12 | $346.74 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $63.10 / $74.13
| Professional | | $63.10 | $63.10 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $43.65 / $120.23
| Professional | | $43.65 | $43.65 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $61.66 / $380.19
| Facility | | $39.81 | $61.66 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $43.65 / $107.15
| Professional | | $26.30 | $43.65 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $43.65 / $66.07
| Facility | | $21.88 | $43.65 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $37.15 / $112.20
| Professional | | $26.30 | $37.15 | $112.20 |