- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $181.97 / $446.68
| Facility | | $61.66 | $181.97 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $39.81 / $128.82
| Professional | | $33.11 | $39.81 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $60.26 / $147.91
| Facility | | $38.90 | $60.26 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $46.77 / $630.96
| Professional | | $25.70 | $46.77 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $104.71 / $151.36
| Facility | | $85.11 | $104.71 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $39.81 / $39.81
| Professional | | $39.81 | $39.81 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $72.44 / $165.96
| Facility | | $34.67 | $72.44 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $47.86 / $114.82
| Professional | | $25.70 | $47.86 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $426.58 / $8,511.38
| Facility | | $56.23 | $426.58 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $72.44
| Professional | | $61.66 | $61.66 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $42.66 / $83.18
| Professional | | $42.66 | $42.66 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $77.62 / $371.54
| Facility | | $54.95 | $77.62 | $371.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $60.26 / $147.91
| Facility | | $38.90 | $60.26 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $46.77 / $630.96
| Professional | | $25.70 | $46.77 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $48.98 / $70.79
| Facility | | $38.02 | $48.98 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $38.02 / $38.02
| Professional | | $38.02 | $38.02 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $42.66 / $70.79
| Facility | | $36.31 | $42.66 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $42.66 / $91.20
| Professional | | $25.70 | $42.66 | $91.20 |