- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $102.33 / $446.68
| Facility | | $51.29 | $102.33 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $50.12 / $51.29
| Professional | | $46.77 | $50.12 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $18.62 / $30.20
| Facility | | $8.91 | $18.62 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $47.86 / $81.28
| Professional | | $47.86 | $47.86 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $8.91
| Professional | | $8.91 | $8.91 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $97.72 / $128.82
| Facility | | $51.29 | $97.72 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $51.29 / $51.29
| Professional | | $51.29 | $51.29 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $134.90 / $151.36
| Professional | | $21.88 | $134.90 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $36.31
| Professional | | $9.77 | $9.77 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $47.86 / $74.13
| Facility | | $8.91 | $47.86 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $46.77 / $58.88
| Professional | | $44.67 | $46.77 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $51.29 / $75.86
| Facility | | $47.86 | $51.29 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $51.29 / $75.86
| Professional | | $47.86 | $51.29 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $251.19 / $323.59
| Facility | | $138.04 | $251.19 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $53.70 / $58.88
| Professional | | $50.12 | $53.70 | $58.88 |