- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $79.43 / $138.04
| Facility | | $40.74 | $79.43 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $40.74 / $123.03
| Professional | | $32.36 | $40.74 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $53.70 / $95.50
| Facility | | $46.77 | $53.70 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $66.07 / $128.82
| Professional | | $56.23 | $66.07 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $58.88 / $72.44
| Facility | | $40.74 | $58.88 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $61.66 / $69.18
| Professional | | $51.29 | $61.66 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $67.61 / $263.03
| Facility | | $50.12 | $67.61 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $45.71 / $114.82
| Professional | | $23.44 | $45.71 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $33.11 / $173.78
| Facility | | $33.11 | $33.11 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $28.18 / $141.25
| Professional | | $23.44 | $28.18 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $46.77 / $63.10
| Professional | | $38.90 | $46.77 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $61.66
| Facility | | $61.66 | $61.66 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $57.54 / $120.23
| Professional | | $43.65 | $57.54 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $51.29 / $77.62
| Facility | | $30.90 | $51.29 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $30.90 / $61.66
| Professional | | $21.38 | $30.90 | $61.66 |