- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $302.00 / $891.25
| Facility | | $30.90 | $302.00 | $891.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $26.30 / $38.90
| Professional | | $20.89 | $26.30 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.85 / $27.54
| Professional | | $10.00 | $15.85 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $100.00 / $100.00
| Facility | | $60.26 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $100.00 / $100.00
| Professional | | $72.44 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $83.18 / $199.53
| Facility | | $2.29 | $83.18 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $39.81 / $125.89
| Professional | | $9.77 | $39.81 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $12.02 / $26.92
| Facility | | $7.59 | $12.02 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $9.12 / $24.55
| Professional | | $6.03 | $9.12 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $27.54 / $40.74
| Professional | | $16.98 | $27.54 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $89.13 / $134.90
| Facility | | $24.55 | $89.13 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $50,118.72 / $75,857.76
| Facility | | $54.95 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $147.91 / $416.87
| Facility | | $20.42 | $147.91 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $19.95 / $72.44
| Professional | | $10.96 | $19.95 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $28.84 / $38.90
| Facility | | $8.71 | $28.84 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $33.88 / $75.86
| Professional | | $20.42 | $33.88 | $75.86 |