- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $97.72 / $154.88
| Facility | | $51.29 | $97.72 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $45.71 / $102.33
| Professional | | $33.88 | $45.71 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $51.29 / $134.90
| Facility | | $51.29 | $51.29 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $25.12 / $117.49
| Professional | | $25.12 | $25.12 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $51.29 / $51.29
| Facility | | $30.90 | $51.29 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $51.29 / $51.29
| Professional | | $37.15 | $51.29 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $109.65 / $186.21
| Facility | | $50.12 | $109.65 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $72.44 / $245.47
| Professional | | $34.67 | $72.44 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $66.07 / $141.25
| Facility | | $45.71 | $66.07 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $45.71 / $97.72
| Professional | | $36.31 | $45.71 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $51.29 / $51.29
| Facility | | $51.29 | $51.29 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $51.29 / $69.18
| Professional | | $43.65 | $51.29 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $234.42 / $234.42 / $234.42
| Facility | | $234.42 | $234.42 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $102.33 / $50,118.72
| Facility | | $66.07 | $102.33 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $51.29 / $64.57
| Professional | | $51.29 | $51.29 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $61.66 / $75.86
| Facility | | $51.29 | $61.66 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $43.65 / $117.49
| Professional | | $21.38 | $43.65 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $51.29 / $69.18
| Facility | | $43.65 | $51.29 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $53.70 / $91.20
| Professional | | $43.65 | $53.70 | $91.20 |