- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $53.70 / $446.68
| Facility | | $31.62 | $53.70 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $32.36 / $60.26
| Professional | | $16.22 | $32.36 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $47.86 / $67.61 / $102.33
| Professional | 50 | $47.86 | $67.61 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $27.54 / $30.90
| Professional | | $15.85 | $27.54 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- 50
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $36.31
| Professional | 50 | $36.31 | $36.31 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $416.87 / $851.14
| Facility | | $302.00 | $416.87 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $457.09 / $630.96 / $1,288.25
| Facility | 50 | $457.09 | $630.96 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $42.66 / $67.61
| Professional | | $25.12 | $42.66 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $33.11 / $39.81
| Facility | | $33.11 | $33.11 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $38.02 / $75.86
| Professional | | $17.78 | $38.02 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $40.74 / $74.13
| Facility | | $24.55 | $40.74 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $281.84 / $630.96 / $1,148.15
| Facility | 50 | $281.84 | $630.96 | $1,148.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $39.81 / $66.07
| Professional | | $24.55 | $39.81 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $32.36 / $33.11
| Professional | | $14.79 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $53.70 / $70.79
| Facility | | $40.74 | $53.70 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $37.15 / $38.02
| Facility | | $29.51 | $37.15 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $38.02 / $70.79
| Professional | | $23.44 | $38.02 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $436.52 / $851.14
| Facility | | $288.40 | $436.52 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- 50
- Typical Low / Median / Typical High
- $436.52 / $660.69 / $1,288.25
| Facility | 50 | $436.52 | $660.69 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $41.69 / $66.07
| Professional | | $25.12 | $41.69 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $575.44 / $1,288.25
| Facility | | $151.36 | $575.44 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $39.81 / $64.57
| Professional | | $23.44 | $39.81 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $33.11 / $60.26
| Professional | | $31.62 | $33.11 | $60.26 |