- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $95.50 / $257.04
| Facility | | $43.65 | $95.50 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $40.74 / $64.57
| Professional | | $30.20 | $40.74 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $64.57 / $87.10
| Facility | | $45.71 | $64.57 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $39.81 / $43.65
| Professional | | $33.11 | $39.81 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $97.72 / $141.25
| Facility | | $45.71 | $97.72 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $46.77 / $69.18
| Professional | | $26.92 | $46.77 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $38.90 / $64.57
| Professional | | $28.18 | $38.90 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $43.65 / $89.13
| Facility | | $43.65 | $43.65 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $43.65 / $89.13
| Professional | | $43.65 | $43.65 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $77.62 / $134.90
| Facility | | $43.65 | $77.62 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $39.81 / $52.48
| Professional | | $39.81 | $39.81 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $66.07 / $117.49
| Facility | | $50.12 | $66.07 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $39.81 / $43.65
| Professional | | $33.11 | $39.81 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $52.48 / $52.48
| Facility | | $39.81 | $52.48 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $25.70 / $56.23
| Professional | | $18.62 | $25.70 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $22.91 / $79.43
| Professional | | $19.95 | $22.91 | $79.43 |