- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $85.11 / $245.47
| Facility | | $34.67 | $85.11 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $32.36 / $87.10
| Professional | | $23.99 | $32.36 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $45.71 / $117.49
| Facility | | $29.51 | $45.71 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $44.67 / $398.11
| Professional | | $29.51 | $44.67 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $87.10 / $173.78
| Facility | | $63.10 | $87.10 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $32.36
| Professional | | $32.36 | $32.36 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $54.95 / $123.03
| Facility | | $26.92 | $54.95 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $37.15 / $91.20
| Professional | | $20.89 | $37.15 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $316.23 / $8,511.38
| Facility | | $50.12 | $316.23 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $58.88
| Professional | | $50.12 | $50.12 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $50.12 / $91.20
| Professional | | $29.51 | $50.12 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $45.71 / $117.49
| Facility | | $29.51 | $45.71 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $44.67 / $398.11
| Professional | | $29.51 | $44.67 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $34.67 / $52.48
| Facility | | $26.92 | $34.67 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $48.98 / $104.71
| Professional | | $26.92 | $48.98 | $104.71 |