- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $181.97 / $234.42
| Facility | | $151.36 | $181.97 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $15.14 / $19.95
| Professional | | $8.91 | $15.14 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $39.81 / $74.13
| Professional | | $21.38 | $39.81 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $85.11 / $138.04
| Facility | | $23.99 | $85.11 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $38.90 / $44.67
| Professional | | $17.78 | $38.90 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $16.98 / $25.12
| Facility | | $3.39 | $16.98 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $85.11 / $91.20
| Professional | | $23.44 | $85.11 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $20.89 / $1,348.96
| Facility | | $12.30 | $20.89 | $1,348.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $42.66
| Professional | | $20.42 | $20.42 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $54.95 / $85.11
| Professional | | $50.12 | $54.95 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $21.88 / $21.88
| Facility | | $21.88 | $21.88 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $34.67 / $34.67
| Professional | | $34.67 | $34.67 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $50.12 / $69.18
| Professional | | $23.44 | $50.12 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $138.04
| Facility | | $17.78 | $17.78 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $32.36 / $138.04
| Professional | | $17.78 | $32.36 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $47.86
| Facility | | $20.42 | $20.42 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $20.89 / $27.54
| Professional | | $20.89 | $20.89 | $27.54 |