- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $44.67 / $5,623.41
| Facility | | $30.90 | $44.67 | $5,623.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $21.88 / $5,248.07
| Professional | | $19.95 | $21.88 | $5,248.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $20.42
| Professional | | $20.42 | $20.42 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $23.99 / $50.12
| Facility | | $21.38 | $23.99 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $21.38 / $58.88
| Professional | | $20.42 | $21.38 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $22.91 / $34.67
| Facility | | $19.95 | $22.91 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $26.92 / $57.54
| Professional | | $20.89 | $26.92 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $35.48 / $47.86
| Facility | | $21.38 | $35.48 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $20.42
| Professional | | $20.42 | $20.42 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $22.39 / $44.67
| Professional | | $18.62 | $22.39 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $102.33 / $102.33
| Facility | | $102.33 | $102.33 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $30.90 / $51.29
| Facility | | $20.42 | $30.90 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $25.12
| Professional | | $20.42 | $20.42 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $22.39 / $34.67
| Professional | | $16.60 | $22.39 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $20.42
| Facility | | $20.42 | $20.42 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $47.86
| Professional | | $20.42 | $20.42 | $47.86 |