- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $120.23 / $295.12
| Facility | | $36.31 | $120.23 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $38.90 / $51.29
| Professional | | $36.31 | $38.90 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $48.98 / $208.93
| Facility | | $48.98 | $48.98 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $23.99 / $38.02
| Professional | | $23.99 | $23.99 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $229.09 / $346.74
| Professional | | $144.54 | $229.09 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $125.89 / $223.87
| Facility | | $50.12 | $125.89 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $36.31 / $85.11
| Professional | | $26.92 | $36.31 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $58.88 / $72.44
| Professional | | $48.98 | $58.88 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $81.28 / $95.50
| Professional | | $40.74 | $81.28 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $51.29
| Facility | | $44.67 | $44.67 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $83.18 / $102.33
| Professional | | $51.29 | $83.18 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $79.43 / $10,000.00
| Facility | | $43.65 | $79.43 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $83.18 / $10,000.00
| Professional | | $43.65 | $83.18 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $48.98 / $85.11
| Facility | | $20.42 | $48.98 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $29.51 / $51.29
| Professional | | $20.42 | $29.51 | $51.29 |