- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $53.70 / $95.50
| Facility | | $37.15 | $53.70 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $58.88 / $114.82
| Professional | | $40.74 | $58.88 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $61.66 / $69.18
| Professional | | $48.98 | $61.66 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $63.10 / $97.72
| Professional | | $46.77 | $63.10 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $50.12
| Professional | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $51.29 / $74.13
| Facility | | $43.65 | $51.29 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $64.57 / $123.03
| Professional | | $57.54 | $64.57 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $61.66 / $72.44
| Facility | | $41.69 | $61.66 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $67.61 / $123.03
| Professional | | $47.86 | $67.61 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $72.44 / $72.44
| Facility | | $72.44 | $72.44 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $67.61 / $114.82
| Professional | | $47.86 | $67.61 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $46.77 / $69.18
| Professional | | $32.36 | $46.77 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $64.57 / $102.33
| Professional | | $43.65 | $64.57 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $69.18 / $85.11
| Facility | | $58.88 | $69.18 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $61.66 / $100.00
| Professional | | $42.66 | $61.66 | $100.00 |