- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $107.15 / $177.83
| Facility | | $58.88 | $107.15 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $48.98 / $109.65
| Professional | | $33.11 | $48.98 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $58.88 / $151.36
| Facility | | $58.88 | $58.88 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $23.44 / $120.23
| Professional | | $23.44 | $23.44 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $58.88 / $58.88
| Facility | | $35.48 | $58.88 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $58.88 / $58.88
| Professional | | $42.66 | $58.88 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $147.91 / $467.74
| Facility | | $57.54 | $147.91 | $467.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $70.79 / $281.84
| Professional | | $35.48 | $70.79 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $58.88 / $162.18
| Facility | | $26.92 | $58.88 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $50.12 / $112.20
| Professional | | $40.74 | $50.12 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $56.23 / $104.71
| Professional | | $50.12 | $56.23 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $109.65 / $50,118.72
| Facility | | $53.70 | $109.65 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $58.88 / $60.26
| Professional | | $58.88 | $58.88 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $63.10 / $72.44
| Facility | | $53.70 | $63.10 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $48.98 / $128.82
| Professional | | $24.55 | $48.98 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $67.61 / $134.90
| Facility | | $37.15 | $67.61 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $58.88 / $158.49
| Professional | | $50.12 | $58.88 | $158.49 |