- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $66.07 / $190.55
| Facility | | $27.54 | $66.07 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $18.20 / $54.95
| Professional | | $15.14 | $18.20 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $28.84 / $128.82
| Facility | | $18.62 | $28.84 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $20.42 / $48.98
| Professional | | $12.30 | $20.42 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $50.12 / $72.44
| Facility | | $39.81 | $50.12 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $25.70
| Professional | | $19.05 | $19.05 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $32.36 / $77.62
| Facility | | $15.85 | $32.36 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $23.44 / $53.70
| Professional | | $12.30 | $23.44 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $147.91 / $7,079.46
| Facility | | $23.44 | $147.91 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $29.51 / $34.67
| Professional | | $29.51 | $29.51 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $54.95
| Professional | | $20.42 | $20.42 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $47.86 / $158.49
| Facility | | $23.99 | $47.86 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $28.84 / $128.82
| Facility | | $18.62 | $28.84 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $20.42 / $48.98
| Professional | | $12.30 | $20.42 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $20.42 / $33.11
| Facility | | $11.75 | $20.42 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $16.98 / $54.95
| Professional | | $12.30 | $16.98 | $54.95 |