- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $104.71 / $323.59
| Facility | | $38.90 | $104.71 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- 25
- Typical Low / Median / Typical High
- $89.13 / $251.19 / $549.54
| Facility | 25 | $89.13 | $251.19 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $53.70 / $147.91
| Professional | | $28.18 | $53.70 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $33.88 / $63.10 / $151.36
| Professional | 25 | $33.88 | $63.10 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $64.57 / $114.82
| Professional | | $38.90 | $64.57 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $42.66 / $61.66
| Facility | | $33.11 | $42.66 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $66.07 / $123.03
| Professional | | $52.48 | $66.07 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $177.83 / $281.84
| Facility | | $134.90 | $177.83 | $281.84 |
- 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
- $35.48 / $81.28 / $162.18
| Professional | | $35.48 | $81.28 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $42.66 / $85.11
| Facility | | $25.12 | $42.66 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $89.13 / $144.54
| Professional | | $57.54 | $89.13 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $44.67 / $97.72
| Facility | | $25.70 | $44.67 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- 25
- Typical Low / Median / Typical High
- $109.65 / $109.65 / $109.65
| Facility | 25 | $109.65 | $109.65 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $93.33 / $100.00 / $100.00
| Facility | 62 | $93.33 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $15.14 / $15.85 / $15.85
| Facility | AS | $15.14 | $15.85 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $97.72 / $354.81
| Professional | | $45.71 | $97.72 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $85.11 / $114.82 / $147.91
| Professional | 25 | $85.11 | $114.82 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $74.13
| Professional | | $32.36 | $33.11 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $70.79 / $112.20
| Professional | | $40.74 | $70.79 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $87.10 / $144.54
| Professional | | $46.77 | $87.10 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $66.07 / $223.87
| Facility | | $66.07 | $66.07 | $223.87 |
- 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
- $40.74 / $40.74 / $141.25
| Facility | 62 | $40.74 | $40.74 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $6.61 / $6.61 / $22.39
| Facility | AS | $6.61 | $6.61 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $72.44 / $354.81
| Professional | | $34.67 | $72.44 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $42.66 / $66.07
| Professional | | $42.66 | $42.66 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $72.44 / $117.49
| Professional | | $42.66 | $72.44 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $45.71 / $61.66
| Facility | | $33.11 | $45.71 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $95.50 / $138.04
| Professional | | $56.23 | $95.50 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $70.79 / $79.43 / $91.20
| Professional | 25 | $70.79 | $79.43 | $91.20 |