- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $138.04 / $660.69
| Facility | | $17.38 | $138.04 | $660.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $23.44 / $194.98
| Professional | | $10.96 | $23.44 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $20.42 / $32.36
| Professional | | $13.49 | $20.42 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $45.71 / $109.65
| Professional | | $16.22 | $45.71 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $45.71 / $125.89
| Professional | | $14.79 | $45.71 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $44.67 / $123.03
| Facility | | $14.45 | $44.67 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $40.74 / $112.20
| Professional | | $13.49 | $40.74 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $32.36 / $33.11
| Professional | | $9.33 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $97.72 / $97.72
| Facility | | $58.88 | $97.72 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $69.18 / $69.18
| Facility | | $69.18 | $69.18 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $69.18 / $123.03
| Professional | | $16.60 | $69.18 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $45.71 / $107.15
| Professional | | $16.22 | $45.71 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $34.67 / $48.98
| Facility | | $8.32 | $34.67 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $51.29 / $109.65
| Professional | | $16.60 | $51.29 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $61.66 / $117.49
| Professional | | $45.71 | $61.66 | $117.49 |