- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $81.28 / $190.55
| Facility | | $45.71 | $81.28 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $48.98 / $131.83
| Professional | | $35.48 | $48.98 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $19.50 / $38.90
| Professional | | $15.14 | $19.50 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $52.48 / $81.28
| Facility | | $37.15 | $52.48 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $31.62 / $35.48
| Professional | | $26.30 | $31.62 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $72.44 / $91.20
| Facility | | $30.90 | $72.44 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $37.15 / $51.29
| Professional | | $18.62 | $37.15 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $30.90 / $37.15
| Professional | | $22.39 | $30.90 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $35.48 / $70.79
| Facility | | $35.48 | $35.48 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $35.48 / $66.07
| Professional | | $35.48 | $35.48 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $61.66 / $109.65
| Facility | | $35.48 | $61.66 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $42.66
| Professional | | $31.62 | $31.62 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $52.48 / $91.20
| Facility | | $40.74 | $52.48 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $33.88 / $35.48
| Professional | | $26.30 | $33.88 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $42.66 / $42.66
| Facility | | $33.88 | $42.66 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $19.05 / $48.98
| Professional | | $14.79 | $19.05 | $48.98 |