- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $190.55 / $630.96
| Facility | | $43.65 | $190.55 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $37.15 / $81.28
| Professional | | $26.92 | $37.15 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $21.88 / $41.69
| Professional | | $14.45 | $21.88 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $125.89 / $234.42
| Facility | | $44.67 | $125.89 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $22.91 / $41.69
| Professional | | $5.01 | $22.91 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $64.57 / $467.74
| Facility | | $38.02 | $64.57 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $41.69 / $70.79
| Professional | | $28.84 | $41.69 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $41.69
| Facility | | $40.74 | $40.74 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $91.20 / $223.87
| Facility | | $47.86 | $91.20 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $31.62 / $69.18
| Professional | | $23.44 | $31.62 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $194.98 / $194.98
| Facility | | $194.98 | $194.98 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $60.26 / $77.62
| Professional | | $37.15 | $60.26 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $77.62 / $575.44
| Facility | | $32.36 | $77.62 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $37.15 / $74.13
| Professional | | $23.99 | $37.15 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $34.67 / $34.67
| Professional | | $30.90 | $34.67 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $41.69 / $120.23
| Facility | | $32.36 | $41.69 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $31.62 / $69.18
| Professional | | $23.44 | $31.62 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $41.69 / $48.98
| Facility | | $18.62 | $41.69 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $23.99 / $43.65
| Professional | | $17.38 | $23.99 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $21.38 / $41.69
| Professional | | $16.22 | $21.38 | $41.69 |