- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $83.18 / $39,810.72
| Facility | | $36.31 | $83.18 | $39,810.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $43.65
| Professional | | $36.31 | $36.31 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $36.31 / $67.61
| Professional | | $30.90 | $36.31 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $36.31
| Facility | | $36.31 | $36.31 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $36.31 / $39.81
| Professional | | $30.20 | $36.31 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $54.95 / $72.44
| Facility | | $42.66 | $54.95 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $36.31
| Professional | | $36.31 | $36.31 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $36.31
| Facility | | $36.31 | $36.31 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $36.31 / $36.31
| Professional | | $18.20 | $36.31 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $93.33 / $144.54
| Professional | | $85.11 | $93.33 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $66.07
| Facility | | $36.31 | $36.31 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $38.02 / $40.74
| Professional | | $36.31 | $38.02 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $36.31
| Professional | | $36.31 | $36.31 | $36.31 |