- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $69.18 / $204.17
| Facility | | $56.23 | $69.18 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $41.69 / $85.11
| Professional | | $28.18 | $41.69 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $117.49 / $154.88
| Facility | | $72.44 | $117.49 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $50.12 / $81.28
| Professional | | $13.80 | $50.12 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $97.72 / $117.49
| Professional | | $48.98 | $97.72 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $44.67 / $66.07
| Facility | | $43.65 | $44.67 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $48.98 / $66.07
| Professional | | $42.66 | $48.98 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $91.20
| Facility | | $44.67 | $44.67 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $48.98 / $91.20
| Professional | | $44.67 | $48.98 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $63.10 / $131.83
| Facility | | $43.65 | $63.10 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $53.70 / $79.43
| Professional | | $43.65 | $53.70 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $134.90 / $177.83
| Facility | | $67.61 | $134.90 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $38.02 / $53.70
| Professional | | $35.48 | $38.02 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $67.61 / $72.44
| Facility | | $53.70 | $67.61 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $53.70
| Professional | | $19.05 | $19.05 | $53.70 |