- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $57.54 / $83.18
| Facility | | $18.20 | $57.54 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $19.95 / $33.88
| Professional | | $15.85 | $19.95 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $29.51 / $120.23
| Facility | | $19.05 | $29.51 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $25.70 / $61.66
| Professional | | $15.49 | $25.70 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $51.29 / $72.44
| Facility | | $40.74 | $51.29 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $23.99 / $25.12
| Professional | | $23.99 | $23.99 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $33.11 / $75.86
| Facility | | $17.78 | $33.11 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $28.84 / $44.67
| Professional | | $15.14 | $28.84 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $34.67 / $4,897.79
| Facility | | $26.30 | $34.67 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $33.11 / $43.65
| Professional | | $28.18 | $33.11 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $60.26
| Professional | | $25.70 | $25.70 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $29.51 / $120.23
| Facility | | $19.05 | $29.51 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $25.70 / $61.66
| Professional | | $15.49 | $25.70 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $24.55 / $30.90
| Facility | | $11.48 | $24.55 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $25.70 / $63.10
| Professional | | $13.18 | $25.70 | $63.10 |