- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $181.97 / $181.97
| Facility | | $144.54 | $181.97 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $263.03 / $426.58
| Professional | | $144.54 | $263.03 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $281.84 / $281.84 / $407.38
| Professional | | $281.84 | $281.84 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $46.77 / $616.60
| Facility | | $43.65 | $46.77 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $46.77 / $616.60
| Professional | | $46.77 | $46.77 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $45.71 / $77.62
| Facility | | $9.77 | $45.71 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $562.34 / $707.95
| Professional | | $35.48 | $562.34 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $45.71 / $45.71
| Professional | | $36.31 | $45.71 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $45.71 / $47.86
| Facility | | $45.71 | $45.71 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $27.54 / $45.71
| Professional | | $25.70 | $27.54 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $50,118.72 / $75,857.76
| Facility | | $97.72 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $28.84 / $1,047.13
| Facility | | $13.18 | $28.84 | $1,047.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $26.92 / $53.70
| Professional | | $16.22 | $26.92 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $45.71 / $257.04
| Facility | | $25.70 | $45.71 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $45.71 / $257.04
| Professional | | $25.70 | $45.71 | $257.04 |