- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $107.15 / $190.55
| Facility | | $38.02 | $107.15 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $38.90 / $83.18
| Professional | | $32.36 | $38.90 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $51.29 / $218.78
| Facility | | $51.29 | $51.29 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $97.72
| Professional | | $56.23 | $56.23 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $489.78 / $1,023.29
| Professional | | $46.77 | $489.78 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $128.82 / $234.42
| Facility | | $52.48 | $128.82 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $31.62 / $91.20
| Professional | | $25.70 | $31.62 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $56.23 / $72.44
| Professional | | $51.29 | $56.23 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $69.18 / $436.52
| Facility | | $40.74 | $69.18 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $107.15 / $436.52
| Professional | | $33.11 | $107.15 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $74.13 / $10,000.00
| Facility | | $46.77 | $74.13 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $74.13 / $10,000.00
| Professional | | $46.77 | $74.13 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $51.29 / $61.66
| Facility | | $30.90 | $51.29 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $25.70 / $56.23
| Professional | | $21.38 | $25.70 | $56.23 |