- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $77.62 / $112.20
| Facility | | $32.36 | $77.62 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $19.95 / $44.67
| Professional | | $15.85 | $19.95 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $30.20 / $151.36
| Facility | | $19.50 | $30.20 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $25.12 / $64.57
| Professional | | $14.79 | $25.12 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $52.48 / $75.86
| Facility | | $42.66 | $52.48 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $25.12 / $25.12
| Professional | | $22.91 | $25.12 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $34.67 / $69.18
| Facility | | $17.38 | $34.67 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $30.20 / $69.18
| Professional | | $13.80 | $30.20 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $141.25 / $7,079.46
| Facility | | $20.42 | $141.25 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $38.90 / $45.71
| Professional | | $38.90 | $38.90 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $26.92 / $60.26
| Professional | | $26.92 | $26.92 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $23.44 / $194.98
| Facility | | $16.98 | $23.44 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $30.20 / $151.36
| Facility | | $19.50 | $30.20 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $25.12 / $64.57
| Professional | | $14.79 | $25.12 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $23.99 / $30.20
| Facility | | $12.02 | $23.99 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $20.42 / $61.66
| Professional | | $13.49 | $20.42 | $61.66 |