- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $89.13 / $173.78
| Facility | | $16.98 | $89.13 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $9.55 / $22.91
| Professional | | $3.31 | $9.55 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $25.70 / $45.71
| Facility | | $15.85 | $25.70 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $10.96 / $17.78
| Professional | | $8.13 | $10.96 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $21.38 / $24.55
| Professional | | $19.95 | $21.38 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $34.67 / $154.88
| Facility | | $9.77 | $34.67 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $10.72 / $15.85
| Professional | | $5.25 | $10.72 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $19.50
| Facility | | $9.77 | $9.77 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $11.75
| Professional | | $9.77 | $9.77 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $13.49 / $28.84
| Facility | | $9.55 | $13.49 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $10.72 / $79.43
| Professional | | $8.13 | $10.72 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $186.21 / $229.09
| Facility | | $138.04 | $186.21 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $8.91 / $14.79
| Professional | | $3.89 | $8.91 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $158.49 / $257.04
| Facility | | $7.94 | $158.49 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.89 / $14.79
| Professional | | $4.07 | $5.89 | $14.79 |