- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $45.71 / $134.90
| Facility | | $37.15 | $45.71 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $25.12 / $44.67
| Professional | | $3.02 | $25.12 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $48.98 / $87.10
| Facility | | $48.98 | $48.98 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $33.11 / $53.70
| Professional | | $1.78 | $33.11 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $66.07 / $77.62
| Professional | | $61.66 | $66.07 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $30.20 / $38.90
| Facility | | $21.88 | $30.20 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $30.20 / $43.65
| Professional | | $3.47 | $30.20 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $60.26
| Facility | | $30.20 | $30.20 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $30.20 / $36.31
| Professional | | $2.24 | $30.20 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $41.69 / $87.10
| Facility | | $4.79 | $41.69 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $33.11 / $79.43
| Professional | | $3.47 | $33.11 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $87.10 / $117.49
| Facility | | $44.67 | $87.10 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $22.39 / $36.31
| Professional | | $2.63 | $22.39 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $36.31 / $47.86
| Facility | | $1.62 | $36.31 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $17.78 / $30.20
| Professional | | $2.09 | $17.78 | $30.20 |