- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $61.66 / $302.00
| Facility | | $27.54 | $61.66 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- 25
- Typical Low / Median / Typical High
- $77.62 / $234.42 / $478.63
| Facility | 25 | $77.62 | $234.42 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $53.70 / $117.49
| Professional | | $28.84 | $53.70 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $32.36 / $58.88 / $123.03
| Professional | 25 | $32.36 | $58.88 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $50.12 / $66.07
| Professional | | $29.51 | $50.12 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $34.67 / $54.95 / $63.10
| Professional | 25 | $34.67 | $54.95 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $363.08 / $398.11
| Facility | | $257.04 | $363.08 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.79 / $36.31 / $72.44
| Professional | | $0.79 | $36.31 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $51.29 / $128.82
| Facility | | $51.29 | $51.29 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $51.29 / $79.43
| Professional | | $51.29 | $51.29 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $97.72 / $245.47
| Facility | | $54.95 | $97.72 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $64.57 / $64.57 / $64.57
| Facility | 22 | $64.57 | $64.57 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $33.88
| Facility | 62 | $33.88 | $33.88 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $5.37
| Facility | AS | $5.37 | $5.37 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $54.95 / $114.82
| Professional | | $30.90 | $54.95 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.10 / $0.10 / $41.69
| Facility | | $0.10 | $0.10 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- 25
- Typical Low / Median / Typical High
- $0.10 / $0.10 / $0.10
| Facility | 25 | $0.10 | $0.10 | $0.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $42.66 / $89.13
| Professional | | $36.31 | $42.66 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $69.18 / $91.20 / $177.83
| Professional | 25 | $69.18 | $91.20 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $36.31 / $63.10
| Facility | | $35.48 | $36.31 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $56.23 / $114.82
| Professional | | $37.15 | $56.23 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $38.02 / $85.11
| Professional | | $30.20 | $38.02 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $26.92 / $53.70 / $74.13
| Professional | 25 | $26.92 | $53.70 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $144.54 / $245.47
| Facility | | $66.07 | $144.54 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- 25
- Typical Low / Median / Typical High
- $199.53 / $199.53 / $245.47
| Facility | 25 | $199.53 | $199.53 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $57.54 / $117.49
| Professional | | $41.69 | $57.54 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $46.77 / $48.98 / $75.86
| Professional | 25 | $46.77 | $48.98 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $56.23
| Professional | 50 | $56.23 | $56.23 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $63.10 / $125.89
| Professional | | $52.48 | $63.10 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $56.23 / $79.43
| Professional | | $38.90 | $56.23 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $46.77 / $58.88
| Facility | | $35.48 | $46.77 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $50.12 / $117.49
| Professional | | $33.88 | $50.12 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $54.95 / $79.43 / $100.00
| Professional | 25 | $54.95 | $79.43 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $36.31 / $63.10
| Facility | | $12.30 | $36.31 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $60.26 / $97.72
| Professional | | $38.02 | $60.26 | $97.72 |