- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $61.66 / $125.89
| Facility | | $45.71 | $61.66 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $67.61
| Professional | | $44.67 | $44.67 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $23.44 / $45.71
| Professional | | $18.20 | $23.44 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $45.71 / $52.48
| Facility | | $37.15 | $45.71 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $61.66
| Professional | | $61.66 | $61.66 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $54.95 / $229.09
| Facility | | $43.65 | $54.95 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $36.31 / $87.10
| Professional | | $21.88 | $36.31 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $29.51 / $58.88
| Facility | | $29.51 | $29.51 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $24.55 / $67.61
| Professional | | $15.14 | $24.55 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $37.15 / $54.95
| Professional | | $33.88 | $37.15 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $54.95
| Facility | | $54.95 | $54.95 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $47.86 / $93.33
| Professional | | $31.62 | $47.86 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $45.71 / $67.61
| Facility | | $22.39 | $45.71 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $45.71 / $45.71
| Professional | | $26.92 | $45.71 | $45.71 |