- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $89.13 / $147.91
| Facility | | $32.36 | $89.13 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $32.36 / $102.33
| Professional | | $23.99 | $32.36 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $48.98 / $117.49
| Facility | | $31.62 | $48.98 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $42.66 / $776.25
| Professional | | $28.84 | $42.66 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $85.11 / $134.90
| Facility | | $67.61 | $85.11 | $134.90 |
- 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
- $27.54 / $58.88 / $131.83
| Facility | | $27.54 | $58.88 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $38.02 / $93.33
| Professional | | $20.42 | $38.02 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $269.15 / $8,511.38
| Facility | | $48.98 | $269.15 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $48.98 / $57.54
| Professional | | $48.98 | $48.98 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $47.86 / $87.10
| Professional | | $29.51 | $47.86 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $48.98 / $117.49
| Facility | | $31.62 | $48.98 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $42.66 / $776.25
| Professional | | $28.84 | $42.66 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $34.67 / $56.23
| Facility | | $28.84 | $34.67 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $47.86 / $89.13
| Professional | | $28.84 | $47.86 | $89.13 |