- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $75.86 / $218.78
| Facility | | $25.70 | $75.86 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $18.62 / $37.15
| Professional | | $15.14 | $18.62 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $12.88 / $12.88
| Professional | | $12.88 | $12.88 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $91.20 / $537.03
| Facility | | $31.62 | $91.20 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $147.91 / $5,011.87
| Facility | | $112.20 | $147.91 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $19.95
| Professional | | $16.60 | $16.60 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $32.36 / $72.44
| Facility | | $15.14 | $32.36 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $27.54 / $51.29
| Professional | | $12.59 | $27.54 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.14 / $30.90
| Professional | | $10.00 | $15.14 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $21.38 / $21.38
| Facility | | $21.38 | $21.38 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $23.44 / $37.15
| Professional | | $20.89 | $23.44 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $56.23 / $134.90
| Facility | | $35.48 | $56.23 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $12.88 / $16.98
| Professional | | $12.88 | $12.88 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $87.10 / $199.53
| Facility | | $24.55 | $87.10 | $199.53 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $35.48 / $93.33
| Facility | | $14.79 | $35.48 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $18.20 / $32.36
| Professional | | $14.13 | $18.20 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $891.25 / $1,000.00 / $1,412.54
| Facility | | $891.25 | $1,000.00 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $9.12 / $31.62
| Facility | | $5.50 | $9.12 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $30.20 / $31.62
| Professional | | $5.50 | $30.20 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $21.38 / $25.70
| Facility | | $12.59 | $21.38 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $14.13 / $37.15
| Professional | | $9.55 | $14.13 | $37.15 |