- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $30.20
| Facility | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $19.05 / $34.67
| Professional | | $16.98 | $19.05 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $23.44 / $23.44
| Facility | | $23.44 | $23.44 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $19.95
| Professional | | $19.95 | $19.95 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $70.79 / $89.13
| Professional | | $25.12 | $70.79 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $23.99 / $33.88
| Facility | | $2.51 | $23.99 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $32.36 / $34.67
| Professional | | $30.20 | $32.36 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $33.11 / $34.67
| Facility | | $3.31 | $33.11 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $4.68 / $39.81
| Professional | | $3.31 | $4.68 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $26.30 / $2,691,534.80
| Facility | | $17.38 | $26.30 | $2,691,534.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $23.44 / $79.43
| Professional | | $19.95 | $23.44 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $48.98 / $112.20
| Facility | | $33.88 | $48.98 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $33.88 / $37.15
| Professional | | $24.55 | $33.88 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $16.22 / $25.12
| Facility | | $1.66 | $16.22 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $17.38 / $33.11
| Professional | | $16.98 | $17.38 | $33.11 |