- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $128.82 / $363.08
| Facility | | $58.88 | $128.82 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $120.23 / $251.19
| Professional | | $52.48 | $120.23 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $97.72 / $186.21
| Professional | | $79.43 | $97.72 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $89.13 / $190.55
| Professional | | $72.44 | $89.13 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $53.70 / $125.89
| Facility | | $53.70 | $53.70 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $125.89 / $181.97
| Professional | | $53.70 | $125.89 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $257.04 / $309.03
| Facility | | $194.98 | $257.04 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $199.53 / $467.74
| Professional | | $93.33 | $199.53 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $28.18 / $57.54
| Facility | | $20.89 | $28.18 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $186.21 / $309.03
| Professional | | $112.20 | $186.21 | $309.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $54.95 / $61.66
| Professional | | $50.12 | $54.95 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $128.82 / $302.00
| Facility | | $36.31 | $128.82 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $69.18 / $70.79
| Professional | | $67.61 | $69.18 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $75.86 / $138.04
| Professional | | $63.10 | $75.86 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $186.21 / $204.17
| Facility | | $141.25 | $186.21 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $154.88 / $489.78
| Professional | | $93.33 | $154.88 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $131.83 / $194.98
| Facility | | $95.50 | $131.83 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $162.18 / $316.23
| Professional | | $102.33 | $162.18 | $316.23 |