- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $70.79 / $3,467.37
| Facility | | $26.92 | $70.79 | $3,467.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $38.90
| Professional | | $25.70 | $25.70 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $35.48 / $63.10
| Facility | | $35.48 | $35.48 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $28.18 / $36.31
| Professional | | $28.18 | $28.18 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $57.54 / $117.49
| Facility | | $25.12 | $57.54 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $32.36 / $53.70
| Professional | | $26.92 | $32.36 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $114.82
| Facility | | $20.42 | $20.42 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $40.74 / $138.04
| Professional | | $10.72 | $40.74 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $28.18 / $114.82
| Facility | | $28.18 | $28.18 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $31.62 / $575.44
| Professional | | $28.18 | $31.62 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $64.57 / $74.13
| Professional | | $50.12 | $64.57 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $67.61 / $67.61
| Facility | | $46.77 | $67.61 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $48.98 / $83.18
| Professional | | $37.15 | $48.98 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $38.02 / $70.79
| Professional | | $26.92 | $38.02 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $151.36 / $630.96
| Facility | | $26.30 | $151.36 | $630.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $85.11 / $575.44
| Professional | | $26.30 | $85.11 | $575.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $38.90 / $186.21
| Professional | | $38.02 | $38.90 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $60.26
| Facility | | $25.70 | $25.70 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $29.51 / $131.83
| Professional | | $26.30 | $29.51 | $131.83 |