- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $70.79 / $263.03
| Facility | | $45.71 | $70.79 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $53.70 / $173.78
| Professional | | $38.02 | $53.70 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $53.70 / $112.20
| Professional | | $43.65 | $53.70 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $54.95
| Facility | | $54.95 | $54.95 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $69.18
| Professional | | $54.95 | $54.95 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $173.78 / $50,118.72
| Facility | | $64.57 | $173.78 | $50,118.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $77.62 / $173.78
| Professional | | $47.86 | $77.62 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $40.74 / $102.33
| Facility | | $25.12 | $40.74 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $81.28 / $114.82
| Professional | | $61.66 | $81.28 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.88
| Facility | | $32.36 | $32.36 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $54.95 / $104.71
| Professional | | $39.81 | $54.95 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $398.11 / $398.11 / $398.11
| Facility | | $398.11 | $398.11 | $398.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $50,118.72 / $75,857.76
| Facility | | $69.18 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $81.28 / $131.83
| Professional | | $66.07 | $81.28 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $870.96 / $2,398.83 / $4,897.79
| Facility | | $870.96 | $2,398.83 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $77.62 / $338.84
| Professional | | $44.67 | $77.62 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $107.15
| Facility | | $32.36 | $32.36 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $63.10 / $120.23
| Professional | | $39.81 | $63.10 | $120.23 |