- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $58.88 / $85.11
| Facility | | $22.91 | $58.88 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $46.77 / $72.44
| Professional | | $34.67 | $46.77 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $95.50 / $194.98
| Facility | | $91.20 | $95.50 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $52.48 / $117.49
| Professional | | $43.65 | $52.48 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $77.62
| Professional | | $75.86 | $75.86 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $75.86 / $107.15
| Facility | | $44.67 | $75.86 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $81.28 / $120.23
| Professional | | $57.54 | $81.28 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $54.95
| Facility | | $50.12 | $50.12 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $50.12
| Professional | | $36.31 | $36.31 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $50.12
| Facility | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $50.12
| Professional | | $36.31 | $36.31 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $29.51 / $42.66
| Professional | | $21.38 | $29.51 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $109.65 / $109.65
| Facility | | $109.65 | $109.65 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $102.33 / $186.21
| Professional | | $87.10 | $102.33 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $72.44 / $107.15
| Facility | | $30.20 | $72.44 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $42.66 / $61.66
| Professional | | $29.51 | $42.66 | $61.66 |