- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $52.48 / $151.36
| Facility | | $42.66 | $52.48 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $30.90 / $52.48
| Professional | | $14.13 | $30.90 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $89.13 / $97.72
| Facility | | $54.95 | $89.13 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $37.15 / $60.26
| Professional | | $16.98 | $37.15 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $74.13 / $87.10
| Professional | | $69.18 | $74.13 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $33.88 / $52.48
| Facility | | $33.11 | $33.88 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $39.81 / $48.98
| Professional | | $33.88 | $39.81 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $67.61
| Facility | | $33.88 | $33.88 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $38.90
| Professional | | $33.88 | $33.88 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $46.77 / $100.00
| Facility | | $30.20 | $46.77 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $37.15 / $79.43
| Professional | | $30.20 | $37.15 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $102.33 / $141.25
| Facility | | $51.29 | $102.33 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $30.90 / $40.74
| Professional | | $25.12 | $30.90 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $40.74 / $53.70
| Facility | | $15.49 | $40.74 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $40.74
| Professional | | $14.13 | $14.13 | $40.74 |