- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $87.10 / $123.03
| Facility | | $46.77 | $87.10 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $67.61 / $102.33
| Professional | | $45.71 | $67.61 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $69.18 / $186.21
| Professional | | $69.18 | $69.18 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $89.13 / $89.13
| Facility | | $83.18 | $89.13 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $89.13 / $89.13
| Professional | | $89.13 | $89.13 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $173.78 / $173.78 / $53,703.18
| Facility | | $173.78 | $173.78 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $125.89
| Professional | | $44.67 | $44.67 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $181.97 / $426.58
| Facility | | $109.65 | $181.97 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $117.49 / $208.93
| Professional | | $69.18 | $117.49 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $63.10
| Facility | | $60.26 | $60.26 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $64.57 / $69.18
| Professional | | $60.26 | $64.57 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $50,118.72 / $75,857.76
| Facility | | $128.82 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $104.71 / $104.71
| Professional | | $72.44 | $104.71 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $53.70 / $109.65
| Facility | | $35.48 | $53.70 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $72.44 / $181.97
| Professional | | $37.15 | $72.44 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $64.57 / $72.44
| Facility | | $60.26 | $64.57 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $64.57 / $69.18
| Professional | | $60.26 | $64.57 | $69.18 |