- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $33.88 / $1,905.46
| Facility | | $12.88 | $33.88 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $21.88 / $58.88
| Professional | | $14.13 | $21.88 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,202.26 / $1,584.89 / $6,165.95
| Facility | | $1,202.26 | $1,584.89 | $6,165.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $45.71 / $102.33
| Professional | | $23.99 | $45.71 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $38.02 / $69.18 / $154.88
| Professional | 50 | $38.02 | $69.18 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $75.86 / $120.23
| Facility | | $64.57 | $75.86 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $36.31 / $66.07
| Professional | | $18.62 | $36.31 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $45.71 / $3,981.07
| Facility | | $16.60 | $45.71 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $44.67 / $70.79
| Professional | | $30.20 | $44.67 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $45.71 / $1,737.80
| Facility | | $16.60 | $45.71 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $50.12 / $128.82
| Professional | | $26.30 | $50.12 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $79.43
| Professional | | $32.36 | $33.11 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $891.25 / $2,344.23
| Facility | | $33.88 | $891.25 | $2,344.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $56.23 / $79.43
| Professional | | $26.92 | $56.23 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $50.12 / $85.11
| Professional | | $28.84 | $50.12 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $42.66 / $199.53
| Facility | | $42.66 | $42.66 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $33.11 / $3,890.45
| Professional | | $18.62 | $33.11 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $45.71
| Professional | | $31.62 | $31.62 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $69.18 / $104.71
| Professional | | $37.15 | $69.18 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,023.29 / $1,584.89 / $2,187.76
| Facility | | $1,023.29 | $1,584.89 | $2,187.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $33.88 / $87.10
| Professional | | $18.62 | $33.88 | $87.10 |