- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $38.02 / $239.88
| Professional | | $26.92 | $38.02 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $4.68
| Facility | | $4.68 | $4.68 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $50.12 / $181.97
| Professional | | $33.11 | $50.12 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $117.49 / $177.83
| Facility | | $104.71 | $117.49 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $89.13 / $234.42
| Professional | | $85.11 | $89.13 | $234.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $41.69 / $58.88
| Facility | | $41.69 | $41.69 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $41.69 / $70.79
| Professional | | $35.48 | $41.69 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $64.57 / $75.86
| Professional | | $64.57 | $64.57 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $56.23 / $95.50
| Professional | | $47.86 | $56.23 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $309.03 / $309.03 / $309.03
| Facility | | $309.03 | $309.03 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $46.77 / $91.20
| Facility | | $28.84 | $46.77 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $41.69 / $51.29
| Professional | | $35.48 | $41.69 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $128.82 / $128.82 / $128.82
| Professional | | $128.82 | $128.82 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $64.57 / $64.57
| Professional | | $51.29 | $64.57 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $25.70 / $41.69
| Facility | | $3.02 | $25.70 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $38.02 / $74.13
| Professional | | $30.90 | $38.02 | $74.13 |