- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $51.29 / $204.17
| Facility | | $15.85 | $51.29 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.85 / $30.20
| Professional | | $12.88 | $15.85 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $25.12 / $177.83
| Facility | | $16.22 | $25.12 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $17.78 / $42.66
| Professional | | $8.71 | $17.78 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $42.66 / $61.66
| Facility | | $34.67 | $42.66 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $22.39
| Professional | | $16.60 | $16.60 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $28.18 / $67.61
| Facility | | $13.80 | $28.18 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $20.42 / $45.71
| Professional | | $10.72 | $20.42 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $138.04 / $7,079.46
| Facility | | $20.42 | $138.04 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $30.20
| Professional | | $25.70 | $25.70 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $47.86
| Professional | | $17.78 | $17.78 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $38.90 / $257.04
| Facility | | $16.60 | $38.90 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $25.12 / $177.83
| Facility | | $16.22 | $25.12 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $17.78 / $42.66
| Professional | | $8.71 | $17.78 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $17.78 / $28.84
| Facility | | $10.00 | $17.78 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $14.79 / $44.67
| Professional | | $8.32 | $14.79 | $44.67 |