- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $48.98 / $309.03
| Facility | | $20.42 | $48.98 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $18.20 / $28.18
| Professional | | $15.14 | $18.20 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $11.75 / $18.20
| Professional | | $8.32 | $11.75 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $19.50 / $21.38
| Facility | | $16.60 | $19.50 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $20.42
| Professional | | $18.20 | $18.20 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.79 / $1.05 / $131.83
| Facility | | $0.79 | $1.05 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $12.59 / $46.77
| Professional | | $8.13 | $12.59 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.48 / $28.84 / $162.18
| Facility | | $0.48 | $28.84 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $12.30 / $51.29
| Professional | | $8.13 | $12.30 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $22.39 / $28.84
| Professional | | $14.79 | $22.39 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $208.93 / $208.93
| Facility | | $208.93 | $208.93 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $70.79 / $75.86
| Professional | | $50.12 | $70.79 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $134.90 / $467.74
| Facility | | $123.03 | $134.90 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $11.22 / $16.22
| Professional | | $6.92 | $11.22 | $16.22 |