- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $63.10 / $154.88
| Facility | | $21.88 | $63.10 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $19.50 / $20.89
| Professional | | $16.98 | $19.50 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $30.90 / $123.03
| Facility | | $19.95 | $30.90 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $21.88 / $52.48
| Professional | | $12.88 | $21.88 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $52.48 / $75.86
| Facility | | $42.66 | $52.48 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $27.54
| Professional | | $20.42 | $20.42 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $34.67 / $83.18
| Facility | | $16.98 | $34.67 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $24.55 / $56.23
| Professional | | $13.18 | $24.55 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $169.82 / $7,079.46
| Facility | | $25.12 | $169.82 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $37.15
| Professional | | $31.62 | $31.62 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $21.88 / $58.88
| Professional | | $21.88 | $21.88 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $28.18 / $83.18
| Facility | | $25.70 | $28.18 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $30.90 / $123.03
| Facility | | $19.95 | $30.90 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $21.88 / $52.48
| Professional | | $12.88 | $21.88 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $21.88 / $35.48
| Facility | | $12.30 | $21.88 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $18.20 / $58.88
| Professional | | $12.88 | $18.20 | $58.88 |