- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $52.48 / $85.11
| Facility | | $19.05 | $52.48 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $19.05 / $40.74
| Professional | | $15.14 | $19.05 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $28.18 / $234.42
| Facility | | $18.62 | $28.18 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $20.42 / $48.98
| Professional | | $10.72 | $20.42 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $48.98 / $79.43
| Facility | | $39.81 | $48.98 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $25.70
| Professional | | $19.05 | $19.05 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $32.36 / $77.62
| Facility | | $15.85 | $32.36 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $22.91 / $52.48
| Professional | | $12.30 | $22.91 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $158.49 / $7,079.46
| Facility | | $22.91 | $158.49 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $28.84 / $33.88
| Professional | | $28.84 | $28.84 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $54.95
| Professional | | $20.42 | $20.42 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $28.18 / $234.42
| Facility | | $18.62 | $28.18 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $20.42 / $48.98
| Professional | | $10.72 | $20.42 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $20.42 / $29.51
| Facility | | $10.00 | $20.42 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $16.98 / $54.95
| Professional | | $10.72 | $16.98 | $54.95 |