- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $123.03 / $194.98
| Facility | | $64.57 | $123.03 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $52.48 / $97.72
| Professional | | $47.86 | $52.48 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $64.57 / $169.82
| Facility | | $64.57 | $64.57 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $147.91
| Professional | | $32.36 | $33.11 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $64.57 / $64.57
| Facility | | $38.90 | $64.57 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $64.57 / $64.57
| Professional | | $47.86 | $64.57 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $141.25 / $707.95
| Facility | | $63.10 | $141.25 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $93.33 / $426.58
| Professional | | $43.65 | $93.33 | $426.58 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $74.13 / $177.83
| Facility | | $37.15 | $74.13 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $45.71 / $125.89
| Professional | | $25.70 | $45.71 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $24.55 / $24.55
| Facility | | $24.55 | $24.55 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $38.90 / $67.61
| Professional | | $24.55 | $38.90 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $117.49 / $50,118.72
| Facility | | $36.31 | $117.49 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $77.62 / $107.15
| Facility | | $48.98 | $77.62 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $43.65 / $141.25
| Professional | | $27.54 | $43.65 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $29.51 / $74.13
| Facility | | $24.55 | $29.51 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $54.95 / $181.97
| Professional | | $24.55 | $54.95 | $181.97 |