- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $25.12 / $74.13
| Facility | | $20.42 | $25.12 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $15.14 / $25.12
| Professional | | $7.94 | $15.14 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $33.88 / $47.86
| Facility | | $26.30 | $33.88 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $18.20 / $29.51
| Professional | | $6.46 | $18.20 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $36.31 / $41.69
| Professional | | $33.11 | $36.31 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $16.22 / $25.12
| Facility | | $13.18 | $16.22 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $18.62 / $23.44
| Professional | | $12.88 | $18.62 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $33.11
| Facility | | $16.22 | $16.22 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $33.11
| Professional | | $16.22 | $16.22 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $22.91 / $47.86
| Facility | | $9.33 | $22.91 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $17.78 / $79.43
| Professional | | $12.88 | $17.78 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $138.04 / $229.09
| Facility | | $93.33 | $138.04 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $12.30 / $19.50
| Professional | | $9.77 | $12.30 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $177.83 / $288.40
| Facility | | $6.03 | $177.83 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $6.92 / $19.50
| Professional | | $5.37 | $6.92 | $19.50 |