- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $77.62 / $234.42
| Facility | | $44.67 | $77.62 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $53.70 / $109.65
| Professional | | $30.20 | $53.70 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $40.74 / $69.18
| Professional | | $38.90 | $40.74 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $38.02 / $91.20
| Professional | | $26.92 | $38.02 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $60.26 / $85.11
| Facility | | $35.48 | $60.26 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $64.57 / $95.50
| Professional | | $46.77 | $64.57 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $46.77
| Facility | | $44.67 | $44.67 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $38.02 / $44.67
| Professional | | $38.02 | $38.02 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $46.77
| Facility | | $44.67 | $44.67 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $38.02 / $44.67
| Professional | | $38.02 | $38.02 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $11.75 / $16.98
| Professional | | $8.32 | $11.75 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $81.28 / $147.91
| Professional | | $69.18 | $81.28 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $30.90 / $50.12
| Facility | | $21.88 | $30.90 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $33.88 / $48.98
| Professional | | $23.44 | $33.88 | $48.98 |