- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $147.91 / $229.09
| Facility | | $33.11 | $147.91 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $19.05 / $38.02
| Professional | | $15.14 | $19.05 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $58.88 / $60.26
| Facility | | $46.77 | $58.88 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $87.10
| Professional | | $10.96 | $10.96 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $22.91
| Facility | | $15.14 | $15.14 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $21.88 / $21.88
| Professional | | $21.88 | $21.88 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $70.79 / $112.20
| Facility | | $60.26 | $70.79 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $31.62 / $69.18
| Professional | | $25.12 | $31.62 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $47.86 / $173.78
| Facility | | $19.50 | $47.86 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $22.39 / $123.03
| Facility | | $17.78 | $22.39 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $18.62 / $50.12
| Professional | | $13.18 | $18.62 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $33.11 / $77.62
| Professional | | $18.62 | $33.11 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $26.30 / $63.10
| Facility | | $26.30 | $26.30 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $36.31 / $61.66
| Professional | | $16.60 | $36.31 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $56.23 / $218.78
| Professional | | $29.51 | $56.23 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $43.65 / $123.03
| Facility | | $43.65 | $43.65 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $14.45 / $21.38
| Professional | | $11.75 | $14.45 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $46.77 / $70.79
| Professional | | $46.77 | $46.77 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $87.10 / $120.23
| Professional | | $70.79 | $87.10 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $19.50 / $52.48
| Facility | | $10.96 | $19.50 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $17.78 / $50.12
| Professional | | $10.96 | $17.78 | $50.12 |