- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $81.28 / $295.12
| Facility | | $39.81 | $81.28 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $47.86 / $125.89
| Professional | | $36.31 | $47.86 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $181.97
| Professional | | $17.78 | $17.78 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $29.51 / $229.09
| Facility | | $26.92 | $29.51 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $25.70 / $42.66
| Professional | | $14.13 | $25.70 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $81.28 / $104.71
| Facility | | $25.70 | $81.28 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $32.36 / $85.11
| Professional | | $23.44 | $32.36 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $57.54 / $128.82
| Facility | | $25.12 | $57.54 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $38.02 / $74.13
| Professional | | $20.89 | $38.02 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $38.90 / $56.23
| Professional | | $35.48 | $38.90 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $35.48 / $85.11
| Professional | | $28.18 | $35.48 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $165.96 / $165.96
| Facility | | $165.96 | $165.96 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $60.26 / $208.93
| Professional | | $31.62 | $60.26 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $35.48 / $35.48
| Professional | | $35.48 | $35.48 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $45.71 / $87.10
| Facility | | $33.11 | $45.71 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $35.48 / $79.43
| Professional | | $20.89 | $35.48 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $36.31 / $60.26
| Professional | | $28.18 | $36.31 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $24.55 / $35.48
| Facility | | $15.85 | $24.55 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $26.92 / $93.33
| Professional | | $18.62 | $26.92 | $93.33 |