- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $53.70 / $109.65
| Facility | | $18.20 | $53.70 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $22.91 / $41.69
| Professional | | $16.98 | $22.91 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $32.36 / $134.90
| Facility | | $20.89 | $32.36 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $27.54 / $69.18
| Professional | | $12.02 | $27.54 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $56.23 / $81.28
| Facility | | $45.71 | $56.23 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $26.92 / $26.92
| Professional | | $25.70 | $26.92 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $37.15 / $77.62
| Facility | | $19.05 | $37.15 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $32.36 / $74.13
| Professional | | $15.14 | $32.36 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $158.49 / $7,079.46
| Facility | | $22.91 | $158.49 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $47.86
| Professional | | $40.74 | $40.74 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $28.18 / $63.10
| Professional | | $28.18 | $28.18 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $32.36 / $134.90
| Facility | | $20.89 | $32.36 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $27.54 / $69.18
| Professional | | $12.02 | $27.54 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $25.70 / $33.11
| Facility | | $12.88 | $25.70 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $21.88 / $69.18
| Professional | | $9.77 | $21.88 | $69.18 |