- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $114.82 / $588.84
| Facility | | $23.99 | $114.82 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $18.20 / $26.92
| Professional | | $12.88 | $18.20 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $1.78 / $43.65
| Facility | | $1.10 | $1.78 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $24.55 / $34.67
| Professional | | $12.59 | $24.55 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $36.31 / $46.77
| Professional | | $30.90 | $36.31 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $23.99 / $40.74
| Facility | | $14.45 | $23.99 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $19.95 / $30.20
| Professional | | $12.88 | $19.95 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $33.88 / $33.88
| Facility | | $28.18 | $33.88 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $33.88 / $44.67
| Professional | | $28.18 | $33.88 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $23.44 / $40.74
| Facility | | $13.80 | $23.44 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $28.84 / $79.43
| Professional | | $16.98 | $28.84 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $537.03 / $794.33 / $1,318.26
| Facility | | $537.03 | $794.33 | $1,318.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $48.98 / $61.66
| Professional | | $34.67 | $48.98 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $630.96 / $831.76
| Facility | | $512.86 | $630.96 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $10.23 / $23.99
| Professional | | $6.92 | $10.23 | $23.99 |