- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $91.20 / $275.42
| Facility | | $40.74 | $91.20 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $48.98 / $151.36
| Professional | | $35.48 | $48.98 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $33.11 / $47.86
| Professional | | $20.89 | $33.11 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.92 / $208.93
| Facility | | $6.17 | $6.92 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $6.61 / $15.49
| Professional | | $5.89 | $6.61 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $63.10 / $114.82
| Facility | | $23.99 | $63.10 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.00 / $21.88
| Professional | | $7.41 | $10.00 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $70.79 / $177.83
| Facility | | $30.90 | $70.79 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $44.67 / $102.33
| Professional | | $24.55 | $44.67 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $45.71 / $61.66
| Professional | | $41.69 | $45.71 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $45.71 / $93.33
| Professional | | $37.15 | $45.71 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $194.98 / $194.98
| Facility | | $194.98 | $194.98 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $309.03 / $309.03
| Professional | | $204.17 | $309.03 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $50.12 / $104.71
| Facility | | $41.69 | $50.12 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $46.77 / $87.10
| Professional | | $24.55 | $46.77 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $46.77 / $616.60
| Professional | | $33.11 | $46.77 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $41.69 / $41.69
| Facility | | $17.38 | $41.69 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $29.51 / $102.33
| Professional | | $26.30 | $29.51 | $102.33 |