- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $44.67
| Facility | | $44.67 | $44.67 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $26.92 / $52.48
| Professional | | $20.42 | $26.92 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $33.11 / $33.11
| Facility | | $33.11 | $33.11 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $28.18 / $28.18
| Professional | | $28.18 | $28.18 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $102.33 / $128.82
| Professional | | $38.02 | $102.33 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $39.81 / $63.10
| Facility | | $5.13 | $39.81 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $48.98 / $56.23
| Professional | | $45.71 | $48.98 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $48.98 / $48.98
| Facility | | $4.90 | $48.98 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $6.03 / $48.98
| Professional | | $4.90 | $6.03 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $45.71 / $2,691,534.80
| Facility | | $26.30 | $45.71 | $2,691,534.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $33.11 / $79.43
| Professional | | $28.18 | $33.11 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $74.13 / $169.82
| Facility | | $47.86 | $74.13 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $50.12 / $54.95
| Professional | | $36.31 | $50.12 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $26.92 / $36.31
| Facility | | $2.88 | $26.92 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $27.54 / $48.98
| Professional | | $25.70 | $27.54 | $48.98 |