- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $234.42 / $1,174.90
| Facility | | $70.79 | $234.42 | $1,174.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $154.88 / $295.12
| Professional | | $74.13 | $154.88 | $295.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $102.33 / $154.88
| Professional | | $63.10 | $102.33 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $223.87 / $416.87
| Facility | | $102.33 | $223.87 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $128.82 / $218.78
| Professional | | $70.79 | $128.82 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $251.19 / $3,019.95
| Facility | | $186.21 | $251.19 | $3,019.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $112.20 / $269.15
| Professional | | $75.86 | $112.20 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $128.82 / $154.88
| Facility | | $72.44 | $128.82 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $125.89 / $831.76
| Facility | | $81.28 | $125.89 | $831.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $158.49 / $316.23
| Professional | | $81.28 | $158.49 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $741.31 / $741.31 / $741.31
| Facility | | $741.31 | $741.31 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $588.84 / $588.84 / $588.84
| Facility | 52 | $588.84 | $588.84 | $588.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,862.09 / $1,862.09 / $1,862.09
| Professional | | $1,862.09 | $1,862.09 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $169.82 / $416.87
| Facility | | $74.13 | $169.82 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $154.88 / $288.40
| Professional | | $75.86 | $154.88 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $60.26 / $138.04
| Professional | | $32.36 | $60.26 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $245.47 / $446.68
| Professional | | $75.86 | $245.47 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $169.82 / $398.11
| Facility | | $75.86 | $169.82 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $158.49 / $338.84
| Professional | | $81.28 | $158.49 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $524.81 / $691.83
| Facility | | $138.04 | $524.81 | $691.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $147.91 / $288.40
| Professional | | $74.13 | $147.91 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $162.18 / $194.98
| Professional | | $58.88 | $162.18 | $194.98 |