- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $89.13 / $251.19
| Facility | | $20.89 | $89.13 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $18.20 / $45.71
| Professional | | $15.49 | $18.20 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $14.79 / $14.79
| Professional | | $14.79 | $14.79 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $64.57 / $74.13
| Facility | | $52.48 | $64.57 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $16.60 / $19.05
| Professional | | $14.13 | $16.60 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $48.98 / $107.15
| Facility | | $16.22 | $48.98 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $14.13 / $33.11
| Professional | | $10.96 | $14.13 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $47.86 / $50.12
| Professional | | $16.22 | $47.86 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $17.78 / $28.18
| Facility | | $16.60 | $17.78 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $31.62 / $34.67
| Professional | | $15.85 | $31.62 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $23.44 / $34.67
| Facility | | $11.48 | $23.44 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $11.75 / $27.54
| Professional | | $9.33 | $11.75 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $549.54 / $549.54 / $549.54
| Facility | | $549.54 | $549.54 | $549.54 |