- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $83.18 / $7,413.10
| Facility | | $56.23 | $83.18 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $109.65
| Professional | | $54.95 | $56.23 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $58.88
| Facility | | $56.23 | $56.23 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $56.23
| Professional | | $56.23 | $56.23 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $43.65
| Facility | | $40.74 | $40.74 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $40.74
| Professional | | $40.74 | $40.74 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $74.13 / $85.11
| Facility | | $41.69 | $74.13 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $61.66
| Professional | | $56.23 | $56.23 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $69.18 / $190.55
| Facility | | $52.48 | $69.18 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $58.88 / $58.88 / $74.13
| Professional | | $58.88 | $58.88 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $56.23
| Facility | | $56.23 | $56.23 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $56.23
| Professional | | $56.23 | $56.23 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $50,118.72 / $75,857.76
| Facility | | $70.79 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $60.26
| Professional | | $60.26 | $60.26 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $56.23 / $85.11
| Facility | | $51.29 | $56.23 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $53.70 / $61.66
| Professional | | $48.98 | $53.70 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $64.57
| Facility | | $56.23 | $56.23 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $56.23
| Professional | | $56.23 | $56.23 | $56.23 |