- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $83.18 / $177.83
| Facility | | $10.00 | $83.18 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $46.77 / $57.54
| Professional | | $10.00 | $46.77 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $64.57 / $288.40
| Facility | | $44.67 | $64.57 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $53.70 / $147.91
| Professional | | $14.79 | $53.70 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $120.23 / $173.78
| Facility | | $97.72 | $120.23 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $57.54 / $57.54
| Professional | | $14.79 | $57.54 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $39.81 / $97.72
| Facility | | $12.59 | $39.81 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $66.07 / $158.49
| Professional | | $9.12 | $66.07 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $91.20 / $7,079.46
| Facility | | $13.18 | $91.20 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $87.10 / $102.33
| Professional | | $87.10 | $87.10 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $60.26 / $128.82
| Professional | | $46.77 | $60.26 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $64.57 / $288.40
| Facility | | $44.67 | $64.57 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $53.70 / $147.91
| Professional | | $14.79 | $53.70 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $27.54 / $60.26
| Facility | | $9.55 | $27.54 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $36.31 / $85.11
| Professional | | $9.55 | $36.31 | $85.11 |