- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $323.59 / $602.56
| Facility | | $72.44 | $323.59 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $23.99 / $38.90
| Professional | | $15.85 | $23.99 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $2.69 / $64.57
| Facility | | $1.66 | $2.69 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $29.51 / $61.66
| Professional | | $11.48 | $29.51 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $53.70 / $64.57
| Professional | | $51.29 | $53.70 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $91.20 / $562.34
| Facility | | $18.62 | $91.20 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $20.89 / $38.90
| Professional | | $18.62 | $20.89 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $50.12 / $50.12
| Facility | | $41.69 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $50.12 / $50.12
| Professional | | $41.69 | $50.12 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $32.36 / $64.57
| Facility | | $2.69 | $32.36 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $48.98 / $79.43
| Professional | | $11.75 | $48.98 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $407.38 / $537.03 / $676.08
| Facility | | $407.38 | $537.03 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $43.65 / $83.18
| Professional | | $20.89 | $43.65 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $512.86 / $831.76
| Facility | | $8.71 | $512.86 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $15.14 / $43.65
| Professional | | $10.47 | $15.14 | $43.65 |