- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $83.18 / $275.42
| Facility | | $36.31 | $83.18 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $42.66 / $70.79
| Professional | | $19.05 | $42.66 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $177.83 / $302.00
| Facility | | $61.66 | $177.83 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $31.62 / $79.43
| Professional | | $5.01 | $31.62 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $57.54 / $79.43
| Facility | | $57.54 | $57.54 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $93.33 / $245.47
| Facility | | $25.12 | $93.33 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $29.51 / $87.10
| Professional | | $12.88 | $29.51 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $275.42 / $275.42
| Facility | | $275.42 | $275.42 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $436.52 / $436.52
| Professional | | $288.40 | $436.52 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $57.54 / $107.15
| Facility | | $33.88 | $57.54 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $46.77 / $87.10
| Professional | | $14.45 | $46.77 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $48.98 / $58.88
| Professional | | $48.98 | $48.98 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $52.48 / $141.25
| Facility | | $29.51 | $52.48 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $30.90 / $89.13
| Professional | | $13.49 | $30.90 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $57.54 / $69.18
| Facility | | $16.98 | $57.54 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $24.55 / $34.67
| Professional | | $11.48 | $24.55 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $39.81 / $57.54
| Professional | | $22.39 | $39.81 | $57.54 |