- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $147.91 / $363.08
| Facility | | $60.26 | $147.91 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $30.90 / $114.82
| Professional | | $29.51 | $30.90 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $47.86 / $186.21
| Facility | | $30.90 | $47.86 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $38.90 / $95.50
| Professional | | $22.91 | $38.90 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $83.18 / $120.23
| Facility | | $66.07 | $83.18 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $37.15 / $43.65
| Professional | | $37.15 | $37.15 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $53.70 / $131.83
| Facility | | $27.54 | $53.70 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $44.67 / $102.33
| Professional | | $23.44 | $44.67 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $52.48 / $4,897.79
| Facility | | $39.81 | $52.48 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $51.29 / $66.07
| Professional | | $43.65 | $51.29 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $38.90 / $102.33
| Professional | | $38.90 | $38.90 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $58.88 / $275.42
| Facility | | $41.69 | $58.88 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $47.86 / $186.21
| Facility | | $30.90 | $47.86 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $38.90 / $95.50
| Professional | | $22.91 | $38.90 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $44.67 / $85.11
| Facility | | $34.67 | $44.67 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $37.15 / $58.88
| Professional | | $34.67 | $37.15 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $38.90 / $54.95
| Facility | | $19.50 | $38.90 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $31.62 / $102.33
| Professional | | $16.60 | $31.62 | $102.33 |