- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $117.49 / $501.19 / $851.14
| Facility | | $117.49 | $501.19 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $79.43 / $457.09
| Professional | | $63.10 | $79.43 | $457.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $229.09 / $234.42
| Facility | | $181.97 | $229.09 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $41.69 / $354.81
| Professional | | $41.69 | $41.69 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $128.82
| Facility | | $85.11 | $85.11 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $114.82
| Professional | | $85.11 | $85.11 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $275.42 / $436.52
| Facility | | $234.42 | $275.42 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $128.82 / $263.03
| Professional | | $61.66 | $128.82 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $467.74 / $676.08
| Facility | | $93.33 | $467.74 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $512.86 / $512.86 / $562.34
| Professional | | $512.86 | $512.86 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $117.49 / $407.38
| Facility | | $75.86 | $117.49 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $74.13 / $549.54
| Professional | | $50.12 | $74.13 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $64.57 / $165.96
| Professional | | $33.11 | $64.57 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $102.33 / $245.47
| Facility | | $102.33 | $102.33 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $144.54 / $239.88
| Professional | | $85.11 | $144.54 | $239.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $199.53 / $295.12
| Professional | | $147.91 | $199.53 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $407.38 / $407.38
| Facility | | $181.97 | $407.38 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $478.63 / $691.83
| Professional | | $102.33 | $478.63 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $181.97 / $186.21
| Professional | | $181.97 | $181.97 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $186.21 / $467.74
| Professional | | $186.21 | $186.21 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $75.86 / $204.17
| Facility | | $30.90 | $75.86 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $95.50 / $363.08
| Professional | | $51.29 | $95.50 | $363.08 |