- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $74.13 / $575.44
| Professional | | $47.86 | $74.13 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $8.71
| Facility | | $8.71 | $8.71 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $109.65 / $309.03
| Professional | | $56.23 | $109.65 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $281.84 / $426.58
| Facility | | $177.83 | $281.84 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $141.25 / $562.34
| Professional | | $79.43 | $141.25 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $95.50 / $134.90
| Facility | | $95.50 | $95.50 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $81.28 / $154.88
| Professional | | $81.28 | $81.28 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $107.15 / $128.82
| Professional | | $107.15 | $107.15 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $107.15 / $181.97
| Professional | | $91.20 | $107.15 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $223.87 / $691.83 / $691.83
| Facility | | $223.87 | $691.83 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $95.50 / $151.36
| Facility | | $42.66 | $95.50 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $81.28 / $102.33
| Professional | | $81.28 | $81.28 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $275.42 / $275.42 / $275.42
| Professional | | $275.42 | $275.42 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $107.15 / $109.65 / $120.23
| Professional | | $107.15 | $109.65 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $42.66 / $85.11
| Facility | | $4.68 | $42.66 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $66.07 / $151.36
| Professional | | $47.86 | $66.07 | $151.36 |