- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $51.29 / $125.89
| Facility | | $21.88 | $51.29 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $22.91 / $36.31
| Professional | | $18.20 | $22.91 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $67.61
| Facility | | $25.70 | $25.70 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $14.45 / $60.26
| Professional | | $12.88 | $14.45 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $25.70 / $25.70
| Facility | | $15.49 | $25.70 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $25.70 / $25.70
| Professional | | $19.05 | $25.70 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $56.23 / $281.84
| Facility | | $25.12 | $56.23 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $37.15 / $190.55
| Professional | | $17.38 | $37.15 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $41.69 / $93.33
| Facility | | $28.84 | $41.69 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $18.20 / $50.12
| Professional | | $12.02 | $18.20 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $25.70 / $33.88
| Professional | | $22.91 | $25.70 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $64.57 / $134.90
| Facility | | $20.42 | $64.57 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $48.98 / $50,118.72
| Facility | | $32.36 | $48.98 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $30.90 / $42.66
| Facility | | $19.50 | $30.90 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $20.42 / $58.88
| Professional | | $10.96 | $20.42 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $29.51 / $83.18
| Facility | | $21.88 | $29.51 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $26.92 / $89.13
| Professional | | $21.88 | $26.92 | $89.13 |