- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $54.95 / $89.13
| Facility | | $20.89 | $54.95 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $19.95 / $56.23
| Professional | | $15.85 | $19.95 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $29.51 / $194.98
| Facility | | $19.05 | $29.51 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $20.89 / $51.29
| Professional | | $12.30 | $20.89 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $51.29 / $74.13
| Facility | | $41.69 | $51.29 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $26.92
| Professional | | $19.95 | $19.95 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $33.11 / $81.28
| Facility | | $16.60 | $33.11 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $24.55 / $54.95
| Professional | | $12.88 | $24.55 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $165.96 / $7,079.46
| Facility | | $23.99 | $165.96 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $35.48
| Professional | | $30.20 | $30.20 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $20.89 / $57.54
| Professional | | $20.89 | $20.89 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $45.71 / $616.60
| Facility | | $45.71 | $45.71 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $29.51 / $194.98
| Facility | | $19.05 | $29.51 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $20.89 / $51.29
| Professional | | $12.30 | $20.89 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $20.89 / $34.67
| Facility | | $12.02 | $20.89 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $17.78 / $57.54
| Professional | | $12.30 | $17.78 | $57.54 |