- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $60.26 / $1,584.89
| Facility | | $18.62 | $60.26 | $1,584.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $23.99
| Professional | | $14.13 | $14.13 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $478.63 / $478.63
| Facility | | $478.63 | $478.63 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.77 / $9.77
| Professional | | $9.33 | $9.77 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.05 / $0.05 / $0.05
| Professional | | $0.05 | $0.05 | $0.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $8.71
| Professional | | $8.71 | $8.71 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $87.10 / $338.84
| Facility | | $74.13 | $87.10 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $478.63 / $478.63
| Facility | | $478.63 | $478.63 | $478.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $16.22
| Facility | | $14.13 | $14.13 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $25.70
| Professional | | $14.13 | $14.13 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.96 / $29.51
| Professional | | $7.08 | $10.96 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $10.23
| Facility | | $7.41 | $7.41 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.23 / $10.23
| Professional | | $7.41 | $10.23 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.17 / $8.91
| Facility | | $4.68 | $6.17 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.03 / $10.96
| Professional | | $4.47 | $6.03 | $10.96 |