- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $38.02 / $77.62
| Facility | | $28.18 | $38.02 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $34.67 / $93.33
| Professional | | $23.99 | $34.67 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $85.11 / $223.87
| Facility | | $37.15 | $85.11 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $51.29 / $128.82
| Professional | | $30.90 | $51.29 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $38.90 / $89.13
| Facility | | $38.90 | $38.90 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $47.86 / $91.20
| Professional | | $33.11 | $47.86 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $63.10 / $104.71
| Professional | | $33.88 | $63.10 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $45.71 / $64.57
| Facility | | $19.50 | $45.71 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $57.54 / $85.11
| Professional | | $31.62 | $57.54 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $58.88 / $104.71
| Professional | | $31.62 | $58.88 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $85.11 / $223.87
| Facility | | $37.15 | $85.11 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $51.29 / $128.82
| Professional | | $30.90 | $51.29 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $30.20
| Professional | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $43.65 / $43.65
| Facility | | $43.65 | $43.65 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $54.95 / $125.89
| Professional | | $32.36 | $54.95 | $125.89 |