- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $102.33 / $234.42
| Facility | | $50.12 | $102.33 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $45.71 / $107.15
| Professional | | $37.15 | $45.71 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $35.48 / $35.48
| Professional | | $30.20 | $35.48 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $53.70 / $93.33
| Facility | | $46.77 | $53.70 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $30.90 / $66.07
| Professional | | $25.12 | $30.90 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $34.67 / $34.67
| Facility | | $34.67 | $34.67 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $40.74
| Professional | | $40.74 | $40.74 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $53.70 / $63.10
| Facility | | $34.67 | $53.70 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $51.29 / $69.18
| Professional | | $33.11 | $51.29 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $66.07 / $208.93
| Facility | | $33.11 | $66.07 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $33.11 / $97.72
| Professional | | $25.70 | $33.11 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $51.29 / $208.93
| Facility | | $28.18 | $51.29 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $32.36 / $85.11
| Professional | | $17.38 | $32.36 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $45.71 / $63.10
| Professional | | $38.02 | $45.71 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $61.66
| Facility | | $61.66 | $61.66 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $53.70 / $104.71
| Professional | | $35.48 | $53.70 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $51.29 / $75.86
| Facility | | $21.38 | $51.29 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $30.20 / $67.61
| Professional | | $21.38 | $30.20 | $67.61 |