- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $66.07 / $104.71
| Facility | | $34.67 | $66.07 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $28.84 / $63.10
| Professional | | $25.70 | $28.84 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $34.67 / $91.20
| Facility | | $34.67 | $34.67 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $50.12
| Professional | | $14.13 | $14.13 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $34.67 / $34.67
| Facility | | $20.89 | $34.67 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $34.67 / $34.67
| Professional | | $25.70 | $34.67 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $74.13 / $125.89
| Facility | | $33.88 | $74.13 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $42.66 / $169.82
| Professional | | $20.89 | $42.66 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $57.54 / $134.90
| Facility | | $34.67 | $57.54 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $30.90 / $66.07
| Professional | | $24.55 | $30.90 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $33.11 / $63.10
| Professional | | $28.18 | $33.11 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $66.07 / $50,118.72
| Facility | | $45.71 | $66.07 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $34.67 / $36.31
| Professional | | $34.67 | $34.67 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $34.67 / $43.65
| Facility | | $31.62 | $34.67 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $24.55 / $56.23
| Professional | | $14.79 | $24.55 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $32.36 / $37.15
| Facility | | $29.51 | $32.36 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $33.11 / $83.18
| Professional | | $28.18 | $33.11 | $83.18 |