- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $123.03 / $154.88
| Facility | | $66.07 | $123.03 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $47.86 / $83.18
| Professional | | $38.90 | $47.86 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $151.36 / $154.88
| Facility | | $120.23 | $151.36 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $22.39 / $223.87
| Professional | | $22.39 | $22.39 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $75.86
| Facility | | $56.23 | $56.23 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $61.66
| Professional | | $56.23 | $56.23 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $177.83 / $288.40
| Facility | | $154.88 | $177.83 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $83.18 / $173.78
| Professional | | $39.81 | $83.18 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $229.09 / $331.13
| Facility | | $64.57 | $229.09 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $331.13 / $331.13 / $371.54
| Professional | | $331.13 | $331.13 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $70.79 / $194.98
| Facility | | $56.23 | $70.79 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $35.48 / $346.74
| Professional | | $25.70 | $35.48 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $64.57 / $85.11
| Professional | | $33.11 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $67.61 / $120.23
| Facility | | $64.57 | $67.61 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $83.18 / $158.49
| Professional | | $52.48 | $83.18 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $141.25 / $190.55
| Professional | | $97.72 | $141.25 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $263.03 / $263.03
| Facility | | $112.20 | $263.03 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $281.84 / $346.74
| Professional | | $53.70 | $281.84 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $42.66 / $117.49
| Professional | | $42.66 | $42.66 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $165.96 / $302.00
| Professional | | $42.66 | $165.96 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $44.67 / $120.23
| Facility | | $19.95 | $44.67 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $34.67 / $85.11
| Professional | | $23.44 | $34.67 | $85.11 |