- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $89.13 / $181.97
| Facility | | $33.88 | $89.13 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $39.81 / $83.18
| Professional | | $30.90 | $39.81 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $46.77 / $199.53
| Facility | | $46.77 | $46.77 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $21.38 / $37.15
| Professional | | $21.38 | $21.38 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $38.90 / $43.65
| Professional | | $36.31 | $38.90 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $117.49 / $436.52
| Facility | | $47.86 | $117.49 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $28.84 / $77.62
| Professional | | $23.44 | $28.84 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $51.29 / $64.57
| Professional | | $46.77 | $51.29 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $52.48 / $81.28
| Facility | | $37.15 | $52.48 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $34.67 / $97.72
| Professional | | $34.67 | $34.67 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $66.07 / $10,000.00
| Facility | | $41.69 | $66.07 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $66.07 / $10,000.00
| Professional | | $41.69 | $66.07 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $46.77 / $63.10
| Facility | | $31.62 | $46.77 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $23.99 / $52.48
| Professional | | $19.50 | $23.99 | $52.48 |