- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $32.36 / $831.76
| Facility | | $20.89 | $32.36 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $25.12 / $32.36
| Professional | | $19.95 | $25.12 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $14.79 / $19.95
| Professional | | $9.33 | $14.79 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $31.62 / $31.62
| Facility | | $7.76 | $31.62 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $31.62
| Professional | | $31.62 | $31.62 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $89.13 / $199.53
| Facility | | $1.45 | $89.13 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $32.36 / $112.20
| Professional | | $13.49 | $32.36 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $30.90 / $50.12
| Facility | | $20.42 | $30.90 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $17.78 / $33.88
| Professional | | $16.60 | $17.78 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $23.44 / $23.44
| Facility | | $23.44 | $23.44 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $25.12 / $69.18
| Professional | | $19.95 | $25.12 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50,118.72 / $53,703.18 / $75,857.76
| Facility | | $50,118.72 | $53,703.18 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $40.74
| Professional | | $33.88 | $33.88 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $38.02 / $144.54
| Facility | | $25.12 | $38.02 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $23.44 / $257.04
| Professional | | $14.13 | $23.44 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $26.92 / $36.31
| Facility | | $10.96 | $26.92 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $31.62 / $75.86
| Professional | | $20.89 | $31.62 | $75.86 |