- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $109.65 / $302.00
| Facility | | $42.66 | $109.65 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $32.36 / $104.71
| Professional | | $29.51 | $32.36 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $24.55 / $38.90
| Professional | | $23.44 | $24.55 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $41.69 / $72.44
| Facility | | $36.31 | $41.69 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $20.89 / $30.20
| Professional | | $16.22 | $20.89 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $26.92 / $26.92
| Facility | | $26.92 | $26.92 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $31.62 / $31.62
| Professional | | $27.54 | $31.62 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $41.69 / $48.98
| Facility | | $26.30 | $41.69 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $38.90 / $52.48
| Professional | | $25.70 | $38.90 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $46.77 / $162.18
| Facility | | $25.70 | $46.77 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $25.70 / $66.07
| Professional | | $18.20 | $25.70 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $114.82 / $239.88
| Facility | | $44.67 | $114.82 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $21.38 / $61.66
| Professional | | $7.24 | $21.38 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $35.48 / $48.98
| Professional | | $29.51 | $35.48 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $46.77 / $46.77
| Facility | | $46.77 | $46.77 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $43.65 / $79.43
| Professional | | $27.54 | $43.65 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $38.90 / $58.88
| Facility | | $16.60 | $38.90 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $23.44 / $47.86
| Professional | | $16.60 | $23.44 | $47.86 |