- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $354.81 / $562.34
| Facility | | $51.29 | $354.81 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $53.70 / $77.62
| Professional | | $44.67 | $53.70 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $44.67 / $234.42
| Professional | | $42.66 | $44.67 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $199.53 / $281.84
| Facility | | $134.90 | $199.53 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $40.74 / $41.69
| Professional | | $28.84 | $40.74 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $134.90 / $295.12
| Facility | | $44.67 | $134.90 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $43.65 / $97.72
| Professional | | $33.11 | $43.65 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $72.44 / $120.23
| Professional | | $53.70 | $72.44 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $58.88 / $125.89
| Facility | | $51.29 | $58.88 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $34.67 / $38.02
| Professional | | $34.67 | $34.67 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $77.62 / $112.20
| Facility | | $32.36 | $77.62 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $44.67 / $93.33
| Professional | | $32.36 | $44.67 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $309.03 / $331.13
| Facility | | $309.03 | $309.03 | $331.13 |