- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $60.26 / $75.86
| Facility | | $32.36 | $60.26 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $22.39 / $40.74
| Professional | | $19.05 | $22.39 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $74.13 / $75.86
| Facility | | $58.88 | $74.13 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $109.65
| Professional | | $10.96 | $10.96 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $87.10 / $138.04
| Facility | | $74.13 | $87.10 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $40.74 / $85.11
| Professional | | $19.50 | $40.74 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $109.65 / $158.49
| Facility | | $32.36 | $109.65 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $162.18 / $181.97
| Professional | | $162.18 | $162.18 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $37.15 / $95.50
| Facility | | $27.54 | $37.15 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $16.98 / $165.96
| Professional | | $13.80 | $16.98 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $54.95 / $70.79
| Professional | | $31.62 | $54.95 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $33.11 / $57.54
| Facility | | $30.90 | $33.11 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $40.74 / $77.62
| Professional | | $25.12 | $40.74 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $69.18 / $93.33
| Professional | | $47.86 | $69.18 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $151.36 / $151.36
| Facility | | $54.95 | $151.36 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $134.90 / $165.96
| Professional | | $25.70 | $134.90 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $57.54
| Professional | | $20.42 | $20.42 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $79.43 / $147.91
| Professional | | $20.42 | $79.43 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $21.88 / $58.88
| Facility | | $9.77 | $21.88 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $16.60 / $42.66
| Professional | | $11.48 | $16.60 | $42.66 |