- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $67.61 / $93.33
| Facility | | $52.48 | $67.61 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $40.74 / $64.57
| Professional | | $23.99 | $40.74 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $54.95 / $72.44
| Professional | | $50.12 | $54.95 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $32.36 / $34.67
| Facility | | $28.84 | $32.36 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $40.74 / $61.66
| Professional | | $30.20 | $40.74 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $43.65 / $83.18
| Professional | | $28.84 | $43.65 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $33.88 / $57.54
| Facility | | $25.70 | $33.88 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $33.88 / $54.95
| Professional | | $25.70 | $33.88 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $29.51 / $33.11
| Professional | | $21.38 | $29.51 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $75.86 / $89.13
| Facility | | $47.86 | $75.86 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $57.54 / $93.33
| Professional | | $35.48 | $57.54 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $45.71 / $45.71
| Facility | | $45.71 | $45.71 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $46.77 / $91.20
| Professional | | $34.67 | $46.77 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $32.36 / $34.67
| Facility | | $28.84 | $32.36 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $40.74 / $60.26
| Professional | | $30.90 | $40.74 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $47.86 / $707.95
| Facility | | $39.81 | $47.86 | $707.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $45.71 / $81.28
| Professional | | $32.36 | $45.71 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $45.71 / $87.10
| Professional | | $41.69 | $45.71 | $87.10 |