- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $218.78 / $977.24
| Facility | | $36.31 | $218.78 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $33.11 / $147.91
| Professional | | $23.99 | $33.11 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $66.07 / $66.07
| Professional | | $66.07 | $66.07 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $11.48 / $151.36
| Facility | | $10.47 | $11.48 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $42.66 / $79.43
| Professional | | $29.51 | $42.66 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $123.03 / $245.47
| Facility | | $56.23 | $123.03 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $39.81 / $81.28
| Professional | | $28.84 | $39.81 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $199.53 / $524.81
| Facility | | $48.98 | $199.53 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $37.15 / $67.61
| Professional | | $23.44 | $37.15 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $38.02 / $51.29
| Professional | | $23.44 | $38.02 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $35.48 / $70.79
| Professional | | $27.54 | $35.48 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $363.08 / $363.08
| Facility | | $190.55 | $363.08 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $190.55 / $245.47 / $245.47
| Professional | | $190.55 | $245.47 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $32.36 / $33.88
| Professional | | $10.47 | $32.36 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $39.81 / $72.44
| Facility | | $26.30 | $39.81 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $38.02 / $74.13
| Professional | | $23.99 | $38.02 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $95.50 / $95.50
| Professional | | $95.50 | $95.50 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $144.54 / $218.78
| Facility | | $33.88 | $144.54 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $30.90 / $95.50
| Professional | | $21.38 | $30.90 | $95.50 |