- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $66.07 / $107.15
| Facility | | $22.91 | $66.07 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $22.91 / $50.12
| Professional | | $21.88 | $22.91 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $35.48 / $138.04
| Facility | | $22.91 | $35.48 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $28.84 / $70.79
| Professional | | $12.30 | $28.84 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $61.66 / $89.13
| Facility | | $48.98 | $61.66 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $27.54 / $32.36
| Professional | | $27.54 | $27.54 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $39.81 / $97.72
| Facility | | $20.42 | $39.81 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $33.11 / $75.86
| Professional | | $17.38 | $33.11 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $169.82 / $7,079.46
| Facility | | $28.84 | $169.82 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $41.69 / $48.98
| Professional | | $41.69 | $41.69 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $28.84 / $70.79
| Professional | | $28.84 | $28.84 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Facility | | $75.86 | $75.86 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $35.48 / $138.04
| Facility | | $22.91 | $35.48 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $28.84 / $70.79
| Professional | | $12.30 | $28.84 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $28.84 / $36.31
| Facility | | $14.45 | $28.84 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $21.88 / $70.79
| Professional | | $11.75 | $21.88 | $70.79 |