- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $64.57 / $181.97
| Facility | | $22.91 | $64.57 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $23.99 / $43.65
| Professional | | $22.91 | $23.99 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $30.90 / $131.83
| Facility | | $30.90 | $30.90 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $23.99
| Professional | | $15.14 | $15.14 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $144.54 / $218.78
| Professional | | $91.20 | $144.54 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $79.43 / $141.25
| Facility | | $31.62 | $79.43 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $22.91 / $50.12
| Professional | | $16.98 | $22.91 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $37.15 / $45.71
| Professional | | $30.90 | $37.15 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $52.48 / $60.26
| Professional | | $25.70 | $52.48 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $28.18 / $29.51
| Facility | | $26.30 | $28.18 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $26.30 / $64.57
| Professional | | $3.98 | $26.30 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $44.67 / $10,000.00
| Facility | | $23.99 | $44.67 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $44.67 / $10,000.00
| Professional | | $23.99 | $44.67 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $30.90 / $53.70
| Facility | | $12.88 | $30.90 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $18.62 / $32.36
| Professional | | $12.88 | $18.62 | $32.36 |