- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $257.04 / $489.78
| Facility | | $39.81 | $257.04 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $26.30 / $40.74
| Professional | | $16.98 | $26.30 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $2.82 / $69.18
| Facility | | $1.74 | $2.82 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $31.62 / $66.07
| Professional | | $12.30 | $31.62 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $57.54 / $69.18
| Professional | | $54.95 | $57.54 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $57.54 / $398.11
| Facility | | $16.22 | $57.54 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $25.12 / $40.74
| Professional | | $17.38 | $25.12 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $53.70 / $53.70
| Facility | | $44.67 | $53.70 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $53.70 / $53.70
| Professional | | $44.67 | $53.70 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $16.98 / $69.18
| Facility | | $2.82 | $16.98 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $52.48 / $79.43
| Professional | | $12.30 | $52.48 | $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
- $22.91 / $46.77 / $89.13
| Professional | | $22.91 | $46.77 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $512.86 / $831.76
| Facility | | $4.68 | $512.86 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $16.22 / $46.77
| Professional | | $9.55 | $16.22 | $46.77 |