- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $63.10 / $125.89
| Facility | | $43.65 | $63.10 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $41.69 / $58.88
| Professional | | $41.69 | $41.69 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $52.48 / $93.33
| Facility | | $52.48 | $52.48 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $42.66 / $53.70
| Professional | | $42.66 | $42.66 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $41.69 / $63.10
| Facility | | $41.69 | $41.69 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $41.69 / $97.72
| Professional | | $41.69 | $41.69 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $63.10 / $112.20
| Facility | | $52.48 | $63.10 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $53.70 / $77.62
| Professional | | $42.66 | $53.70 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $41.69 / $60.26
| Facility | | $41.69 | $41.69 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $85.11 / $91.20
| Professional | | $44.67 | $85.11 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $41.69 / $63.10
| Facility | | $41.69 | $41.69 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $46.77 / $4,073.80
| Professional | | $41.69 | $46.77 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $64.57 / $85.11
| Professional | | $50.12 | $64.57 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $40.74 / $42.66
| Facility | | $38.02 | $40.74 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $42.66 / $72.44
| Professional | | $33.11 | $42.66 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $67.61 / $128.82
| Professional | | $42.66 | $67.61 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $85.11 / $208.93
| Facility | | $42.66 | $85.11 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $69.18 / $4,073.80
| Professional | | $42.66 | $69.18 | $4,073.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $57.54 / $70.79
| Professional | | $38.90 | $57.54 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $95.50
| Facility | | $40.74 | $40.74 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $46.77 / $89.13
| Professional | | $40.74 | $46.77 | $89.13 |