- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $138.04 / $794.33
| Facility | | $18.20 | $138.04 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $21.88 / $28.84
| Professional | | $16.98 | $21.88 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $50.12 / $269.15
| Facility | | $37.15 | $50.12 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $27.54 / $87.10
| Professional | | $11.48 | $27.54 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $208.93 / $295.12
| Facility | | $165.96 | $208.93 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $10.00
| Professional | | $9.12 | $9.12 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $22.91 / $61.66
| Facility | | $1.91 | $22.91 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $26.92 / $83.18
| Professional | | $12.59 | $26.92 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $4,897.79 / $9,772.37
| Facility | | $37.15 | $4,897.79 | $9,772.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $37.15
| Professional | | $31.62 | $31.62 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $27.54 / $63.10
| Professional | | $27.54 | $27.54 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $38.90 / $177.83
| Facility | | $30.90 | $38.90 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $50.12 / $269.15
| Facility | | $37.15 | $50.12 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $27.54 / $87.10
| Professional | | $11.48 | $27.54 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $25.12 / $446.68
| Facility | | $10.00 | $25.12 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $20.89 / $144.54
| Professional | | $7.41 | $20.89 | $144.54 |