- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $144.54 / $354.81
| Facility | | $46.77 | $144.54 | $354.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $109.65 / $251.19
| Professional | | $40.74 | $109.65 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $154.88 / $478.63
| Facility | | $97.72 | $154.88 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $128.82 / $1,174.90
| Professional | | $44.67 | $128.82 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $204.17 / $407.38
| Facility | | $47.86 | $204.17 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $158.49 / $288.40
| Professional | | $47.86 | $158.49 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $380.19 / $575.44
| Facility | | $67.61 | $380.19 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $141.25 / $309.03
| Professional | | $50.12 | $141.25 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $38.90 / $79.43
| Facility | | $19.05 | $38.90 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $125.89 / $234.42
| Professional | | $69.18 | $125.89 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $138.04 / $331.13
| Professional | | $43.65 | $138.04 | $331.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $154.88 / $478.63
| Facility | | $97.72 | $154.88 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $128.82 / $1,174.90
| Professional | | $44.67 | $128.82 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $245.47 / $602.56 / $1,288.25
| Facility | | $245.47 | $602.56 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $125.89 / $346.74
| Professional | | $44.67 | $125.89 | $346.74 |