- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $43.65 / $154.88
| Facility | | $39.81 | $43.65 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $39.81 / $54.95
| Professional | | $19.05 | $39.81 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $41.69 / $87.10
| Professional | | $41.69 | $41.69 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $45.71
| Professional | | $40.74 | $40.74 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $39.81 / $48.98
| Facility | | $39.81 | $39.81 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $39.81
| Professional | | $33.88 | $33.88 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $67.61 / $93.33
| Professional | | $50.12 | $67.61 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $46.77 / $70.79
| Professional | | $33.11 | $46.77 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $47.86 / $79.43
| Facility | | $28.18 | $47.86 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $40.74 / $43.65
| Professional | | $36.31 | $40.74 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $58.88 / $194.98
| Facility | | $44.67 | $58.88 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $58.88 / $194.98
| Professional | | $44.67 | $58.88 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $27.54 / $43.65
| Facility | | $19.50 | $27.54 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $33.11 / $54.95
| Professional | | $29.51 | $33.11 | $54.95 |