- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $102.33 / $229.09
| Facility | | $47.86 | $102.33 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- 25
- Typical Low / Median / Typical High
- $89.13 / $158.49 / $309.03
| Facility | 25 | $89.13 | $158.49 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $85.11 / $186.21
| Professional | | $52.48 | $85.11 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $52.48 / $87.10 / $194.98
| Professional | 25 | $52.48 | $87.10 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $257.04 / $263.03 / $269.15
| Professional | 50 | $257.04 | $263.03 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $85.11 / $128.82
| Professional | | $54.95 | $85.11 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $69.18 / $91.20 / $134.90
| Professional | 25 | $69.18 | $91.20 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $95.50 / $162.18
| Professional | | $61.66 | $95.50 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $125.89 / $151.36
| Facility | | $95.50 | $125.89 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- 22
- Typical Low / Median / Typical High
- $123.03 / $123.03 / $123.03
| Facility | 22 | $123.03 | $123.03 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $63.10 / $63.10 / $63.10
| Facility | 62 | $63.10 | $63.10 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $10.23
| Facility | AS | $10.23 | $10.23 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $81.28 / $147.91
| Professional | | $50.12 | $81.28 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $75.86 / $169.82
| Professional | | $38.90 | $75.86 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $81.28 / $125.89
| Facility | | $51.29 | $81.28 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $39.81 / $186.21
| Professional | | $39.81 | $39.81 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $107.15 / $194.98
| Professional | | $60.26 | $107.15 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $81.28 / $112.20
| Facility | | $81.28 | $81.28 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $69.18 / $117.49
| Professional | | $44.67 | $69.18 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $85.11 / $91.20 / $141.25
| Professional | 25 | $85.11 | $91.20 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $630.96 / $630.96 / $630.96
| Facility | | $630.96 | $630.96 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- 62
- Typical Low / Median / Typical High
- $257.04 / $257.04 / $257.04
| Facility | 62 | $257.04 | $257.04 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- AS
- Typical Low / Median / Typical High
- $41.69 / $41.69 / $41.69
| Facility | AS | $41.69 | $41.69 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $562.34 / $562.34
| Professional | | $562.34 | $562.34 | $562.34 |