- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $63.10 / $245.47
| Facility | | $22.91 | $63.10 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $47.86 / $81.28
| Professional | | $21.88 | $47.86 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $66.07 / $169.82
| Facility | | $24.55 | $66.07 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $54.95 / $158.49
| Professional | | $24.55 | $54.95 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $51.29 / $72.44
| Facility | | $25.70 | $51.29 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $58.88 / $114.82
| Professional | | $25.70 | $58.88 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $61.66 / $128.82
| Professional | | $28.18 | $61.66 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $21.88 / $66.07
| Facility | | $10.72 | $21.88 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $50.12 / $95.50
| Professional | | $28.84 | $50.12 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $56.23 / $131.83
| Professional | | $24.55 | $56.23 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $323.59 / $331.13 / $371.54
| Facility | | $323.59 | $331.13 | $371.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $41.69 / $41.69
| Professional | | $41.69 | $41.69 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $66.07 / $169.82
| Facility | | $24.55 | $66.07 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $54.95 / $158.49
| Professional | | $24.55 | $54.95 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $67.61 / $147.91
| Facility | | $47.86 | $67.61 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $56.23 / $131.83
| Professional | | $24.55 | $56.23 | $131.83 |