- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $81.28 / $114.82
| Facility | | $33.88 | $81.28 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $50.12 / $70.79
| Professional | | $38.90 | $50.12 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $102.33 / $204.17
| Facility | | $102.33 | $102.33 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $53.70 / $165.96
| Professional | | $53.70 | $53.70 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $83.18 / $83.18
| Facility | | $77.62 | $83.18 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $83.18 / $83.18
| Professional | | $83.18 | $83.18 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $57.54 / $53,703.18
| Facility | | $57.54 | $57.54 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $41.69 / $120.23
| Professional | | $41.69 | $41.69 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $169.82 / $389.05
| Facility | | $102.33 | $169.82 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $102.33 / $194.98
| Professional | | $63.10 | $102.33 | $194.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $47.86 / $50.12
| Facility | | $47.86 | $47.86 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $58.88 / $61.66
| Professional | | $47.86 | $58.88 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $50,118.72 / $75,857.76
| Facility | | $102.33 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $97.72 / $97.72
| Professional | | $66.07 | $97.72 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.02 / $52.48 / $281.84
| Facility | | $38.02 | $52.48 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $66.07 / $169.82
| Professional | | $34.67 | $66.07 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $57.54 / $58.88
| Facility | | $47.86 | $57.54 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $58.88 / $61.66
| Professional | | $47.86 | $58.88 | $61.66 |