- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $123.03 / $245.47
| Facility | | $42.66 | $123.03 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $83.18 / $173.78
| Professional | | $28.84 | $83.18 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $70.79 / $77.62
| Professional | | $70.79 | $70.79 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $45.71 / $51.29
| Facility | | $42.66 | $45.71 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $112.20 / $213.80
| Professional | | $43.65 | $112.20 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $75.86 / $131.83
| Facility | | $33.11 | $75.86 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $125.89 / $288.40
| Professional | | $39.81 | $125.89 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $112.20 / $112.20
| Facility | | $93.33 | $112.20 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $85.11 / $177.83
| Professional | | $31.62 | $85.11 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $38.90 / $134.90
| Professional | | $26.92 | $38.90 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $87.10 / $169.82
| Professional | | $24.55 | $87.10 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $295.12 / $295.12 / $295.12
| Facility | | $295.12 | $295.12 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $691.83 / $691.83
| Professional | | $616.60 | $691.83 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $114.82
| Professional | | $32.36 | $33.11 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $70.79
| Professional | | $54.95 | $54.95 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $74.13 / $154.88
| Facility | | $28.18 | $74.13 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $87.10 / $199.53
| Professional | | $32.36 | $87.10 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $97.72 / $275.42
| Professional | | $97.72 | $97.72 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $85.11 / $120.23
| Professional | | $30.20 | $85.11 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $138.04 / $181.97
| Facility | | $114.82 | $138.04 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $66.07 / $169.82
| Professional | | $25.70 | $66.07 | $169.82 |