- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $234.42 / $616.60
| Facility | | $52.48 | $234.42 | $616.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $30.20 / $50.12
| Professional | | $20.89 | $30.20 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $46.77 / $48.98
| Professional | | $27.54 | $46.77 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $758.58 / $1,479.11
| Facility | | $263.03 | $758.58 | $1,479.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $7.59
| Professional | | $7.59 | $7.59 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $398.11 / $912.01
| Facility | | $42.66 | $398.11 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $44.67 / $60.26
| Professional | | $14.79 | $44.67 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $363.08 / $363.08 / $363.08
| Facility | | $363.08 | $363.08 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $69.18 / $181.97
| Facility | | $20.89 | $69.18 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $22.91 / $45.71
| Professional | | $13.80 | $22.91 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $275.42 / $275.42
| Facility | | $275.42 | $275.42 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $74.13 / $74.13
| Professional | | $74.13 | $74.13 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $89.13 / $588.84
| Facility | | $23.99 | $89.13 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $30.20 / $57.54
| Professional | | $20.89 | $30.20 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.59 / $7.59
| Professional | | $5.01 | $7.59 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $2,454.71 / $2,454.71
| Facility | | $1,862.09 | $2,454.71 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $30.90 / $125.89
| Facility | | $20.89 | $30.90 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $16.98 / $43.65
| Professional | | $13.80 | $16.98 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $288.40 / $354.81
| Facility | | $13.80 | $288.40 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $17.78 / $26.92
| Professional | | $12.02 | $17.78 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $21.38 / $28.84
| Professional | | $17.78 | $21.38 | $28.84 |