- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $257.04 / $316.23
| Facility | | $51.29 | $257.04 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $32.36 / $74.13
| Professional | | $23.99 | $32.36 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $44.67 / $154.88
| Professional | | $28.84 | $44.67 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $93.33 / $147.91
| Facility | | $79.43 | $93.33 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $79.43 / $120.23
| Professional | | $30.20 | $79.43 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $51.29 / $309.03
| Facility | | $26.30 | $51.29 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $64.57 / $87.10
| Professional | | $53.70 | $64.57 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $45.71 / $234.42
| Facility | | $25.12 | $45.71 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $54.95 / $190.55
| Professional | | $29.51 | $54.95 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $70.79
| Professional | | $32.36 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $43.65 / $54.95
| Facility | | $43.65 | $43.65 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $57.54 / $120.23
| Professional | | $33.88 | $57.54 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $72.44 / $123.03
| Professional | | $38.02 | $72.44 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $363.08 / $363.08
| Facility | | $70.79 | $363.08 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $138.04 / $190.55
| Professional | | $41.69 | $138.04 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Professional | | $75.86 | $75.86 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $151.36 / $181.97
| Professional | | $56.23 | $151.36 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $104.71 / $302.00
| Facility | | $9.33 | $104.71 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $100.00 / $223.87
| Professional | | $50.12 | $100.00 | $223.87 |