- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $169.82 / $194.98
| Facility | | $16.98 | $169.82 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $30.20 / $66.07
| Professional | | $20.89 | $30.20 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.47 / $4.79
| Professional | | $4.47 | $4.47 | $4.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $8.51 / $208.93
| Facility | | $7.59 | $8.51 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $17.38 / $45.71
| Professional | | $7.24 | $17.38 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $95.50 / $234.42
| Facility | | $38.90 | $95.50 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $16.60 / $30.20
| Professional | | $11.75 | $16.60 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.02 / $3.72 / $89.13
| Facility | | $1.02 | $3.72 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $22.91 / $66.07
| Professional | | $10.72 | $22.91 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Professional | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $50.12 / $398.11
| Professional | | $18.20 | $50.12 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $234.42 / $234.42
| Facility | | $234.42 | $234.42 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $30.20 / $42.66
| Professional | | $22.39 | $30.20 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $19.95 / $23.44
| Professional | | $11.75 | $19.95 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $13.18 / $75.86
| Facility | | $1.29 | $13.18 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $19.95 / $66.07
| Professional | | $10.72 | $19.95 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $19.50 / $25.12
| Facility | | $10.00 | $19.50 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $18.20 / $91.20
| Professional | | $8.51 | $18.20 | $91.20 |