- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $128.82 / $173.78
| Facility | | $39.81 | $128.82 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.18 / $32.36
| Professional | | $10.96 | $13.18 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $38.90 / $39.81
| Facility | | $31.62 | $38.90 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $58.88
| Professional | | $7.24 | $7.24 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $15.14
| Facility | | $9.77 | $9.77 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $14.45
| Professional | | $14.45 | $14.45 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $46.77 / $74.13
| Facility | | $39.81 | $46.77 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $21.38 / $45.71
| Professional | | $16.98 | $21.38 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $31.62 / $117.49
| Facility | | $12.88 | $31.62 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $57.54 / $218.78
| Facility | | $12.88 | $57.54 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $12.02 / $33.11
| Professional | | $8.51 | $12.02 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $30.20 / $64.57
| Professional | | $7.24 | $30.20 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $41.69
| Facility | | $17.38 | $17.38 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $23.99 / $41.69
| Professional | | $10.96 | $23.99 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $37.15 / $117.49
| Professional | | $19.50 | $37.15 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $28.84 / $100.00
| Facility | | $28.84 | $28.84 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $9.55 / $14.45
| Professional | | $7.76 | $9.55 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $30.90 / $31.62
| Professional | | $30.90 | $30.90 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $79.43
| Professional | | $31.62 | $31.62 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $12.88 / $30.20
| Facility | | $7.24 | $12.88 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $11.75 / $33.11
| Professional | | $6.17 | $11.75 | $33.11 |