- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $151.36 / $371.54
| Facility | | $28.84 | $151.36 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $14.79 / $29.51
| Professional | | $12.30 | $14.79 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $44.67 / $45.71
| Facility | | $35.48 | $44.67 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $66.07
| Professional | | $8.13 | $8.13 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $17.38
| Facility | | $11.22 | $11.22 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $16.60
| Professional | | $16.60 | $16.60 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $52.48 / $83.18
| Facility | | $44.67 | $52.48 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $23.99 / $51.29
| Professional | | $19.05 | $23.99 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $36.31 / $131.83
| Facility | | $14.79 | $36.31 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $20.89 / $125.89
| Facility | | $13.49 | $20.89 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $13.49 / $37.15
| Professional | | $9.55 | $13.49 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $33.11 / $64.57
| Professional | | $14.13 | $33.11 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $46.77
| Facility | | $19.95 | $19.95 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $26.92 / $46.77
| Professional | | $12.30 | $26.92 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $41.69 / $138.04
| Professional | | $21.88 | $41.69 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $33.11 / $100.00
| Facility | | $33.11 | $33.11 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $10.96 / $16.22
| Professional | | $8.71 | $10.96 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $26.30 / $34.67
| Professional | | $26.30 | $26.30 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $26.30 / $89.13
| Professional | | $26.30 | $26.30 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $14.79 / $39.81
| Facility | | $8.32 | $14.79 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $13.18 / $40.74
| Professional | | $6.92 | $13.18 | $40.74 |