- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $83.18 / $83.18
| Facility | | $39.81 | $83.18 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $43.65 / $67.61
| Professional | | $30.20 | $43.65 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $63.10 / $79.43
| Professional | | $52.48 | $63.10 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $141.25 / $154.88
| Facility | | $44.67 | $141.25 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $39.81 / $46.77
| Professional | | $32.36 | $39.81 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $33.11 / $58.88
| Facility | | $33.11 | $33.11 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $56.23
| Professional | | $56.23 | $56.23 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $239.88 / $239.88 / $239.88
| Facility | | $239.88 | $239.88 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $457.09 / $457.09
| Professional | | $380.19 | $457.09 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $47.86 / $75.86
| Facility | | $30.20 | $47.86 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $43.65 / $70.79
| Professional | | $30.20 | $43.65 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $33.11
| Professional | | $32.36 | $33.11 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.60 / $107.15 / $158.49
| Professional | | $0.60 | $107.15 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $47.86 / $75.86
| Facility | | $30.20 | $47.86 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $81.28
| Professional | | $56.23 | $56.23 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $57.54 / $95.50
| Professional | | $34.67 | $57.54 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $61.66 / $74.13
| Professional | | $31.62 | $61.66 | $74.13 |