- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $72.44 / $190.55
| Facility | | $26.30 | $72.44 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $25.70 / $75.86
| Professional | | $20.89 | $25.70 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $17.78
| Professional | | $13.49 | $13.49 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $67.61 / $147.91
| Facility | | $15.14 | $67.61 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $30.20 / $63.10
| Professional | | $12.88 | $30.20 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $138.04 / $371.54
| Facility | | $51.29 | $138.04 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $25.70 / $79.43
| Professional | | $19.05 | $25.70 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $51.29 / $97.72
| Facility | | $21.88 | $51.29 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $33.88 / $61.66
| Professional | | $16.60 | $33.88 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $29.51 / $46.77
| Professional | | $26.30 | $29.51 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $29.51 / $66.07
| Professional | | $23.44 | $29.51 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $138.04 / $138.04
| Facility | | $138.04 | $138.04 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $26.30 / $36.31
| Professional | | $25.12 | $26.30 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $32.36 / $75.86
| Facility | | $21.88 | $32.36 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $26.30 / $58.88
| Professional | | $16.60 | $26.30 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $102.33 / $102.33
| Professional | | $102.33 | $102.33 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $28.84 / $44.67
| Professional | | $23.44 | $28.84 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $19.95 / $29.51
| Facility | | $12.30 | $19.95 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $17.38 / $57.54
| Professional | | $12.30 | $17.38 | $57.54 |