- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $93.33 / $138.04
| Facility | | $33.11 | $93.33 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $36.31 / $46.77
| Professional | | $10.00 | $36.31 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $46.77 / $120.23
| Facility | | $46.77 | $46.77 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $18.62 / $67.61
| Professional | | $16.98 | $18.62 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $46.77 / $46.77
| Facility | | $46.77 | $46.77 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $46.77 / $46.77
| Professional | | $33.88 | $46.77 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $100.00 / $165.96
| Facility | | $45.71 | $100.00 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $24.55 / $223.87
| Professional | | $24.55 | $24.55 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $46.77 / $104.71
| Facility | | $12.88 | $46.77 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $37.15 / $89.13
| Professional | | $21.88 | $37.15 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $21.38 / $46.77
| Professional | | $12.59 | $21.38 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $50.12 / $204.17
| Facility | | $33.11 | $50.12 | $204.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $87.10 / $50,118.72
| Facility | | $60.26 | $87.10 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $46.77 / $63.10
| Facility | | $19.50 | $46.77 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $26.30 / $81.28
| Professional | | $12.59 | $26.30 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $52.48 / $52.48
| Facility | | $27.54 | $52.48 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $39.81 / $52.48
| Professional | | $12.88 | $39.81 | $52.48 |