- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $33.88 / $77.62
| Facility | | $25.12 | $33.88 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $45.71 / $97.72
| Professional | | $26.92 | $45.71 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $37.15 / $37.15 / $51.29
| Professional | 25 | $37.15 | $37.15 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $46.77 / $57.54
| Professional | | $39.81 | $46.77 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $33.11 / $83.18
| Facility | | $26.30 | $33.11 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $41.69 / $79.43
| Professional | | $28.18 | $41.69 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $40.74 / $85.11
| Professional | | $26.92 | $40.74 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $43.65 / $79.43
| Professional | | $30.20 | $43.65 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $32.36 / $77.62
| Professional | | $31.62 | $32.36 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $41.69 / $69.18
| Professional | | $24.55 | $41.69 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $223.87 / $223.87
| Facility | | $223.87 | $223.87 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $302.00 / $302.00 / $302.00
| Professional | | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $67.61
| Professional | | $40.74 | $40.74 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $38.02 / $64.57
| Facility | | $27.54 | $38.02 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $45.71 / $79.43
| Professional | | $30.90 | $45.71 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $42.66 / $57.54
| Professional | | $27.54 | $42.66 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $51.29 / $51.29
| Facility | | $51.29 | $51.29 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $39.81 / $95.50
| Professional | | $25.70 | $39.81 | $95.50 |