- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $53.70 / $79.43
| Professional | | $27.54 | $53.70 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $67.61 / $177.83
| Professional | | $67.61 | $67.61 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $60.26 / $79.43
| Facility | | $7.94 | $60.26 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $60.26 / $79.43
| Professional | | $7.94 | $60.26 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $35.48 / $74.13
| Facility | | $35.48 | $35.48 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $35.48 / $74.13
| Professional | | $30.20 | $35.48 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $181.97 / $181.97 / $181.97
| Facility | | $181.97 | $181.97 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $52.48 / $81.28
| Professional | | $50.12 | $52.48 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $61.66
| Facility | | $61.66 | $61.66 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $61.66 / $69.18
| Professional | | $58.88 | $61.66 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $64.57 / $64.57
| Professional | | $64.57 | $64.57 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $31.62 / $52.48
| Facility | | $3.89 | $31.62 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $51.29 / $89.13
| Professional | | $32.36 | $51.29 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $58.88 / $61.66
| Facility | | $57.54 | $58.88 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $61.66 / $61.66
| Professional | | $58.88 | $61.66 | $61.66 |