- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $147.91 / $181.97
| Facility | | $79.43 | $147.91 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $61.66 / $147.91
| Professional | | $50.12 | $61.66 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $144.54 / $177.83 / $181.97
| Facility | | $144.54 | $177.83 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $33.11 / $269.15
| Professional | | $33.11 | $33.11 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $44.67
| Facility | | $44.67 | $44.67 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $213.80 / $338.84
| Facility | | $181.97 | $213.80 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $95.50 / $208.93
| Professional | | $75.86 | $95.50 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $144.54 / $537.03
| Facility | | $56.23 | $144.54 | $537.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $61.66 / $316.23
| Facility | | $52.48 | $61.66 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $54.95 / $151.36
| Professional | | $38.90 | $54.95 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $66.07 / $234.42
| Professional | | $32.36 | $66.07 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $190.55
| Facility | | $79.43 | $79.43 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $109.65 / $190.55
| Professional | | $50.12 | $109.65 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $169.82 / $234.42
| Professional | | $89.13 | $169.82 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $134.90 / $316.23
| Facility | | $134.90 | $134.90 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $46.77 / $70.79
| Professional | | $35.48 | $46.77 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $69.18 / $141.25
| Professional | | $69.18 | $69.18 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $263.03 / $407.38
| Professional | | $69.18 | $263.03 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $58.88 / $79.43
| Facility | | $33.11 | $58.88 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $53.70 / $151.36
| Professional | | $30.20 | $53.70 | $151.36 |