- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $128.82 / $263.03
| Facility | | $69.18 | $128.82 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $58.88 / $162.18
| Professional | | $45.71 | $58.88 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $154.88 / $181.97
| Professional | | $89.13 | $154.88 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $123.03
| Facility | | $79.43 | $79.43 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $83.18 / $123.03
| Professional | | $79.43 | $83.18 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $144.54 / $1,445.44
| Facility | | $104.71 | $144.54 | $1,445.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $117.49 / $371.54
| Professional | | $47.86 | $117.49 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $64.57 / $165.96
| Facility | | $39.81 | $64.57 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $67.61 / $104.71
| Professional | | $51.29 | $67.61 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $63.10 / $63.10
| Facility | | $63.10 | $63.10 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $87.10 / $162.18
| Professional | | $54.95 | $87.10 | $162.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $114.82 / $53,703.18
| Facility | | $81.28 | $114.82 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $85.11 / $151.36
| Professional | | $69.18 | $85.11 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $588.84 / $776.25 / $870.96
| Facility | | $588.84 | $776.25 | $870.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $77.62 / $251.19
| Professional | | $50.12 | $77.62 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $63.10 / $467.74
| Facility | | $46.77 | $63.10 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $87.10 / $162.18
| Professional | | $52.48 | $87.10 | $162.18 |