- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $51.29 / $89.13
| Facility | | $30.20 | $51.29 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $38.02 / $77.62
| Professional | | $28.18 | $38.02 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $30.90 / $77.62
| Professional | | $24.55 | $30.90 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $40.74
| Facility | | $11.75 | $11.75 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $40.74 / $52.48
| Professional | | $11.75 | $40.74 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $97.72 / $239.88
| Facility | | $70.79 | $97.72 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $48.98 / $147.91
| Professional | | $30.20 | $48.98 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $38.02 / $102.33
| Facility | | $24.55 | $38.02 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $47.86 / $77.62
| Professional | | $38.02 | $47.86 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $15.14
| Facility | | $15.14 | $15.14 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $47.86 / $89.13
| Professional | | $30.20 | $47.86 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $58.88 / $53,703.18
| Facility | | $29.51 | $58.88 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $48.98 / $97.72
| Professional | | $41.69 | $48.98 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $181.97 / $213.80
| Facility | | $67.61 | $181.97 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $50.12 / $141.25
| Professional | | $32.36 | $50.12 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $28.84 / $89.13
| Facility | | $15.14 | $28.84 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $47.86 / $95.50
| Professional | | $30.20 | $47.86 | $95.50 |