- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $213.80 / $616.60
| Facility | | $33.11 | $213.80 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $25.70 / $87.10
| Professional | | $23.99 | $25.70 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $56.23
| Professional | | $56.23 | $56.23 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $17.38 / $33.88
| Professional | | $15.85 | $17.38 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $58.88 / $58.88
| Facility | | $25.70 | $58.88 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $58.88 / $61.66
| Professional | | $31.62 | $58.88 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $97.72 / $389.05
| Facility | | $33.88 | $97.72 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $51.29 / $281.84
| Professional | | $26.30 | $51.29 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $25.70 / $95.50
| Facility | | $12.88 | $25.70 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $36.31 / $97.72
| Professional | | $15.85 | $36.31 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $35.48 / $42.66
| Professional | | $27.54 | $35.48 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $43.65 / $436.52
| Facility | | $32.36 | $43.65 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $43.65 / $43.65
| Professional | | $42.66 | $43.65 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $64.57 / $50,118.72
| Facility | | $28.84 | $64.57 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $45.71 / $56.23
| Facility | | $25.70 | $45.71 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $29.51 / $89.13
| Professional | | $16.22 | $29.51 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $43.65 / $77.62
| Facility | | $21.88 | $43.65 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $38.02 / $112.20
| Professional | | $28.18 | $38.02 | $112.20 |