- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $91.20 / $128.82
| Facility | | $38.02 | $91.20 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $60.26 / $83.18
| Professional | | $43.65 | $60.26 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $114.82 / $229.09
| Facility | | $114.82 | $114.82 | $229.09 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $63.10 / $190.55
| Professional | | $63.10 | $63.10 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $95.50 / $95.50
| Facility | | $87.10 | $95.50 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $95.50 / $95.50
| Professional | | $95.50 | $95.50 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $53,703.18
| Facility | | $75.86 | $75.86 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $141.25
| Professional | | $54.95 | $54.95 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $114.82 / $190.55 / $446.68
| Facility | | $114.82 | $190.55 | $446.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $114.82 / $218.78
| Professional | | $72.44 | $114.82 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $72.44 / $75.86
| Facility | | $72.44 | $72.44 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $72.44 / $72.44
| Professional | | $67.61 | $72.44 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $50,118.72 / $75,857.76
| Facility | | $154.88 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $109.65 / $109.65
| Professional | | $75.86 | $109.65 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $60.26 / $316.23
| Facility | | $42.66 | $60.26 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $75.86 / $190.55
| Professional | | $43.65 | $75.86 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $70.79 / $75.86
| Facility | | $67.61 | $70.79 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $72.44 / $72.44
| Professional | | $67.61 | $72.44 | $72.44 |