- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $64.57 / $120.23
| Facility | | $28.84 | $64.57 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $30.20 / $48.98
| Professional | | $25.12 | $30.20 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $87.10
| Facility | | $33.88 | $33.88 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $17.38 / $79.43
| Professional | | $16.60 | $17.38 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $33.88 / $33.88
| Facility | | $20.42 | $33.88 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $33.88 / $33.88
| Professional | | $24.55 | $33.88 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $74.13 / $363.08
| Facility | | $33.11 | $74.13 | $363.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $60.26 / $302.00
| Professional | | $22.91 | $60.26 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $43.65 / $123.03
| Facility | | $30.20 | $43.65 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $23.44 / $66.07
| Professional | | $13.49 | $23.44 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $6.76
| Facility | | $6.76 | $6.76 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $32.36 / $44.67
| Professional | | $6.76 | $32.36 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $30.20 / $169.82
| Facility | | $2.95 | $30.20 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $60.26 / $50,118.72
| Facility | | $14.79 | $60.26 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $40.74 / $54.95
| Facility | | $25.70 | $40.74 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $26.30 / $75.86
| Professional | | $14.13 | $26.30 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $16.98 / $81.28
| Facility | | $6.76 | $16.98 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $33.88 / $107.15
| Professional | | $6.76 | $33.88 | $107.15 |