- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $70.79 / $117.49
| Facility | | $30.90 | $70.79 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $31.62 / $53.70
| Professional | | $26.92 | $31.62 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $95.50
| Facility | | $36.31 | $36.31 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $19.05 / $85.11
| Professional | | $18.20 | $19.05 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $36.31 / $36.31
| Facility | | $21.88 | $36.31 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $36.31 / $36.31
| Professional | | $26.92 | $36.31 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $79.43 / $398.11
| Facility | | $35.48 | $79.43 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $51.29 / $245.47
| Professional | | $24.55 | $51.29 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $47.86 / $120.23
| Facility | | $29.51 | $47.86 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $25.70 / $70.79
| Professional | | $17.38 | $25.70 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $36.31 / $53.70
| Professional | | $32.36 | $36.31 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $36.31 / $131.83
| Facility | | $29.51 | $36.31 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $69.18 / $50,118.72
| Facility | | $45.71 | $69.18 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $44.67 / $60.26
| Facility | | $27.54 | $44.67 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $29.51 / $81.28
| Professional | | $15.49 | $29.51 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $41.69 / $117.49
| Facility | | $30.90 | $41.69 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $38.02 / $125.89
| Professional | | $30.90 | $38.02 | $125.89 |