- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $74.13 / $154.88
| Facility | | $29.51 | $74.13 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $31.62 / $64.57
| Professional | | $20.42 | $31.62 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $35.48 / $91.20
| Facility | | $35.48 | $35.48 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $67.61
| Professional | | $14.13 | $14.13 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $35.48 / $35.48
| Facility | | $20.89 | $35.48 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $35.48 / $35.48
| Professional | | $25.70 | $35.48 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $75.86 / $91.20
| Facility | | $33.88 | $75.86 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $51.29 / $169.82
| Professional | | $21.38 | $51.29 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $45.71 / $95.50
| Facility | | $28.18 | $45.71 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $31.62 / $66.07
| Professional | | $24.55 | $31.62 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $21.88 / $21.88
| Facility | | $21.88 | $21.88 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $33.11 / $42.66
| Professional | | $21.88 | $33.11 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $87.10 / $154.88
| Facility | | $13.80 | $87.10 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $23.44 / $23.44
| Professional | | $23.44 | $23.44 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $66.07 / $50,118.72
| Facility | | $45.71 | $66.07 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $35.48 / $36.31
| Professional | | $35.48 | $35.48 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $35.48 / $43.65
| Facility | | $31.62 | $35.48 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $29.51 / $79.43
| Professional | | $14.79 | $29.51 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $25.70 / $41.69
| Facility | | $21.88 | $25.70 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $33.11 / $63.10
| Professional | | $21.88 | $33.11 | $63.10 |