- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $83.18 / $295.12
| Facility | | $23.44 | $83.18 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $23.44 / $46.77
| Professional | | $12.02 | $23.44 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $50.12 / $81.28
| Facility | | $19.05 | $50.12 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $17.38 / $41.69
| Professional | | $10.47 | $17.38 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $21.38 / $34.67
| Facility | | $17.38 | $21.38 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $16.22
| Professional | | $16.22 | $16.22 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $12.88 / $28.18
| Facility | | $11.75 | $12.88 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $19.95 / $26.30
| Professional | | $10.23 | $19.95 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $100.00 / $8,511.38
| Facility | | $18.20 | $100.00 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $24.55 / $28.84
| Professional | | $24.55 | $24.55 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $37.15
| Professional | | $17.38 | $17.38 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $81.28 / $229.09
| Facility | | $22.91 | $81.28 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $50.12 / $81.28
| Facility | | $19.05 | $50.12 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $17.38 / $41.69
| Professional | | $10.47 | $17.38 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $19.50 / $30.20
| Facility | | $12.88 | $19.50 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.14 / $25.70
| Professional | | $12.88 | $15.14 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $17.38 / $20.89
| Facility | | $8.71 | $17.38 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $13.80 / $41.69
| Professional | | $8.71 | $13.80 | $41.69 |