- 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
- $28.84 / $34.67 / $52.48
| Professional | | $28.84 | $34.67 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $117.49 / $120.23
| Facility | | $95.50 | $117.49 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $151.36
| Professional | | $17.78 | $17.78 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $25.70
| Facility | | $25.70 | $25.70 | $25.70 |
- 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
- $50.12 / $63.10 / $138.04
| Professional | | $50.12 | $63.10 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $87.10 / $144.54
| Facility | | $21.88 | $87.10 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $39.81 / $208.93
| Facility | | $21.88 | $39.81 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $26.30 / $67.61
| Professional | | $14.79 | $26.30 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $37.15 / $85.11
| Professional | | $24.55 | $37.15 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $52.48 / $67.61
| Facility | | $47.86 | $52.48 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $44.67 / $125.89
| Professional | | $33.11 | $44.67 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $104.71 / $147.91
| Professional | | $58.88 | $104.71 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $87.10 / $208.93
| Facility | | $87.10 | $87.10 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $17.78
| Professional | | $12.02 | $12.02 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $93.33
| Professional | | $18.62 | $18.62 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $72.44 / $239.88
| Professional | | $18.62 | $72.44 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $35.48 / $52.48
| Facility | | $15.85 | $35.48 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $26.30 / $66.07
| Professional | | $15.14 | $26.30 | $66.07 |