- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $147.91 / $316.23
| Facility | | $44.67 | $147.91 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.79 / $97.72
| Professional | | $12.02 | $14.79 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $43.65 / $44.67
| Facility | | $34.67 | $43.65 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $64.57
| Professional | | $8.13 | $8.13 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $16.98
| Facility | | $11.22 | $11.22 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $16.22
| Professional | | $16.22 | $16.22 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $52.48 / $83.18
| Facility | | $44.67 | $52.48 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $23.44 / $51.29
| Professional | | $18.62 | $23.44 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $35.48 / $128.82
| Facility | | $14.45 | $35.48 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $70.79 / $177.83
| Facility | | $14.45 | $70.79 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $13.80 / $37.15
| Professional | | $9.55 | $13.80 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $33.11 / $64.57
| Professional | | $16.22 | $33.11 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $19.50 / $46.77
| Facility | | $19.50 | $19.50 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $26.92 / $45.71
| Professional | | $12.30 | $26.92 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $41.69 / $125.89
| Professional | | $21.88 | $41.69 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $100.00
| Facility | | $32.36 | $32.36 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $10.72 / $15.85
| Professional | | $8.71 | $10.72 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $21.38 / $34.67
| Professional | | $21.38 | $21.38 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $47.86 / $89.13
| Professional | | $21.38 | $47.86 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $14.45 / $38.90
| Facility | | $8.13 | $14.45 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $13.18 / $37.15
| Professional | | $8.13 | $13.18 | $37.15 |