- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $97.72 / $120.23
| Facility | | $52.48 | $97.72 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $40.74 / $66.07
| Professional | | $32.36 | $40.74 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $117.49 / $120.23
| Facility | | $93.33 | $117.49 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $21.38 / $181.97
| Professional | | $21.38 | $21.38 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $141.25 / $223.87
| Facility | | $120.23 | $141.25 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $66.07 / $134.90
| Professional | | $46.77 | $66.07 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $251.19 / $380.19
| Facility | | $47.86 | $251.19 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $263.03 / $288.40
| Professional | | $263.03 | $263.03 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $56.23 / $151.36
| Facility | | $38.90 | $56.23 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $35.48 / $158.49
| Professional | | $25.12 | $35.48 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $64.57 / $85.11
| Professional | | $50.12 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $52.48 / $67.61
| Facility | | $46.77 | $52.48 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $74.13 / $123.03
| Professional | | $43.65 | $74.13 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $109.65 / $154.88
| Professional | | $75.86 | $109.65 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $208.93 / $208.93
| Facility | | $95.50 | $208.93 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $218.78 / $218.78
| Professional | | $52.48 | $218.78 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $93.33
| Professional | | $44.67 | $44.67 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $239.88
| Professional | | $44.67 | $44.67 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $38.90 / $104.71
| Facility | | $15.85 | $38.90 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $33.88 / $66.07
| Professional | | $18.20 | $33.88 | $66.07 |