- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $190.55 / $398.11
| Facility | | $61.66 | $190.55 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $61.66 / $288.40
| Professional | | $46.77 | $61.66 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $91.20 / $331.13
| Facility | | $58.88 | $91.20 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $64.57 / $186.21
| Professional | | $38.90 | $64.57 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $125.89 / $158.49 / $229.09
| Facility | | $125.89 | $158.49 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $83.18
| Professional | | $60.26 | $60.26 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $102.33 / $251.19
| Facility | | $50.12 | $102.33 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $74.13 / $165.96
| Professional | | $38.90 | $74.13 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $512.86 / $7,079.46
| Facility | | $56.23 | $512.86 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $93.33 / $109.65
| Professional | | $93.33 | $93.33 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $64.57 / $194.98
| Professional | | $64.57 | $64.57 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $141.25 / $346.74
| Facility | | $74.13 | $141.25 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $91.20 / $331.13
| Facility | | $58.88 | $91.20 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $64.57 / $186.21
| Professional | | $38.90 | $64.57 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $64.57 / $93.33
| Facility | | $32.36 | $64.57 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $64.57 / $281.84
| Professional | | $38.90 | $64.57 | $281.84 |