- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $109.65 / $234.42
| Facility | | $37.15 | $109.65 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $43.65 / $102.33
| Professional | | $26.92 | $43.65 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $17.38 / $72.44
| Professional | | $9.55 | $17.38 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $91.20 / $112.20
| Facility | | $75.86 | $91.20 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $35.48 / $120.23
| Professional | | $26.30 | $35.48 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $75.86 / $158.49
| Facility | | $28.84 | $75.86 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $25.70 / $58.88
| Professional | | $16.22 | $25.70 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $48.98 / $48.98
| Professional | | $48.98 | $48.98 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $46.77 / $87.10
| Facility | | $28.18 | $46.77 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $38.02 / $38.02
| Professional | | $38.02 | $38.02 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $194.98 / $194.98 / $398.11
| Facility | | $194.98 | $194.98 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $35.48 / $97.72
| Professional | | $22.91 | $35.48 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $45.71 / $61.66
| Facility | | $29.51 | $45.71 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $20.89 / $54.95
| Professional | | $14.79 | $20.89 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $165.96 / $165.96
| Facility | | $165.96 | $165.96 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $316.23 / $316.23 / $316.23
| Professional | | $316.23 | $316.23 | $316.23 |