- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $69.18 / $213.80
| Facility | | $43.65 | $69.18 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $64.57
| Professional | | $32.36 | $32.36 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $39.81 / $79.43
| Facility | | $34.67 | $39.81 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $67.61
| Professional | | $32.36 | $33.11 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $36.31 / $56.23
| Facility | | $31.62 | $36.31 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $38.90 / $70.79
| Professional | | $32.36 | $38.90 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $56.23 / $77.62
| Facility | | $33.88 | $56.23 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $35.48
| Professional | | $32.36 | $32.36 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $43.65
| Professional | | $32.36 | $32.36 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $35.48 / $63.10
| Professional | | $28.84 | $35.48 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $162.18 / $162.18
| Facility | | $162.18 | $162.18 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $141.25 / $141.25 / $141.25
| Professional | | $141.25 | $141.25 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $35.48 / $58.88
| Facility | | $32.36 | $35.48 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $40.74
| Professional | | $32.36 | $32.36 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $35.48 / $54.95
| Professional | | $26.30 | $35.48 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $32.36 / $38.90
| Professional | | $31.62 | $32.36 | $38.90 |