- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $173.78 / $851.14
| Facility | | $46.77 | $173.78 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $25.12 / $37.15
| Professional | | $19.95 | $25.12 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $17.38 / $758.58
| Facility | | $15.49 | $17.38 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $26.92 / $107.15
| Professional | | $14.79 | $26.92 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $120.23 / $275.42
| Facility | | $38.02 | $120.23 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $28.18 / $42.66
| Professional | | $21.38 | $28.18 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.93 / $3.39 / $104.71
| Facility | | $0.93 | $3.39 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $22.91 / $64.57
| Professional | | $12.59 | $22.91 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Professional | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $89.13 / $398.11
| Professional | | $33.88 | $89.13 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $223.87 / $223.87
| Facility | | $223.87 | $223.87 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $91.20 / $181.97
| Professional | | $19.95 | $91.20 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $18.62 / $72.44
| Facility | | $1.32 | $18.62 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $21.38 / $69.18
| Professional | | $12.59 | $21.38 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $12.59
| Professional | | $12.59 | $12.59 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $14.79 / $426.58
| Facility | | $10.96 | $14.79 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $15.14 / $81.28
| Professional | | $9.77 | $15.14 | $81.28 |