- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $60.26 / $263.03
| Facility | | $32.36 | $60.26 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $33.88 / $89.13
| Professional | | $20.89 | $33.88 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $26.92 / $67.61
| Professional | | $21.38 | $26.92 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $33.11
| Facility | | $11.22 | $11.22 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $33.11 / $43.65
| Professional | | $11.22 | $33.11 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $79.43 / $173.78
| Facility | | $57.54 | $79.43 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $41.69 / $117.49
| Professional | | $25.12 | $41.69 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $30.20 / $81.28
| Facility | | $19.50 | $30.20 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $41.69 / $64.57
| Professional | | $31.62 | $41.69 | $64.57 |
- 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
- $20.89 / $40.74 / $74.13
| Professional | | $20.89 | $40.74 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $30.90 / $30.90
| Professional | | $30.90 | $30.90 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $47.86 / $53,703.18
| Facility | | $23.99 | $47.86 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $41.69 / $83.18
| Professional | | $34.67 | $41.69 | $83.18 |
- 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
- $26.30 / $41.69 / $123.03
| Professional | | $26.30 | $41.69 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $20.42 / $67.61
| Facility | | $15.14 | $20.42 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $40.74 / $77.62
| Professional | | $20.89 | $40.74 | $77.62 |