- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $128.82 / $389.05
| Facility | | $32.36 | $128.82 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $26.92 / $47.86
| Professional | | $15.14 | $26.92 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $75.86 / $933.25
| Facility | | $26.92 | $75.86 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,174.90 / $1,258.93 / $57,543.99
| Facility | | $1,174.90 | $1,258.93 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $28.18 / $50.12
| Professional | | $22.91 | $28.18 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $30.20 / $51.29
| Professional | | $16.22 | $30.20 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $44.67 / $45.71
| Professional | | $25.70 | $44.67 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $33.88 / $57.54
| Professional | | $19.05 | $33.88 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $147.91 / $501.19
| Facility | | $44.67 | $147.91 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $32.36
| Professional | | $32.36 | $32.36 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $75.86 / $954.99
| Facility | | $26.92 | $75.86 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $34.67 / $269.15
| Facility | | $18.20 | $34.67 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $28.18 / $46.77
| Professional | | $15.85 | $28.18 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $26.92 / $26.92
| Facility | | $26.92 | $26.92 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $72.44
| Professional | | $33.88 | $33.88 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $18.62 / $29.51
| Facility | | $12.02 | $18.62 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $18.62 / $30.20
| Professional | | $12.02 | $18.62 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $204.17 / $467.74 / $3,890.45
| Facility | | $204.17 | $467.74 | $3,890.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $28.18 / $50.12
| Professional | | $15.14 | $28.18 | $50.12 |