- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $40.74 / $40.74
| Facility | | $39.81 | $40.74 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $41.69 / $50.12
| Professional | | $39.81 | $41.69 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $56.23 / $114.82
| Professional | | $35.48 | $56.23 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $85.11 / $147.91
| Facility | | $39.81 | $85.11 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $48.98 / $74.13
| Professional | | $30.20 | $48.98 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $40.74 / $57.54
| Facility | | $34.67 | $40.74 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $109.65 / $144.54
| Professional | | $38.90 | $109.65 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $40.74 / $57.54
| Facility | | $34.67 | $40.74 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $44.67 / $229.09
| Professional | | $40.74 | $44.67 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $60.26 / $70.79
| Professional | | $54.95 | $60.26 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $77.62 / $114.82
| Professional | | $45.71 | $77.62 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $54.95 / $2,041.74
| Facility | | $30.20 | $54.95 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $74.13 / $229.09
| Professional | | $30.20 | $74.13 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $63.10 / $79.43
| Professional | | $63.10 | $63.10 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $79.43
| Facility | | $33.88 | $33.88 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $42.66 / $47.86
| Professional | | $40.74 | $42.66 | $47.86 |