- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $45.71 / $56.23
| Facility | | $32.36 | $45.71 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $30.20 / $40.74
| Professional | | $22.91 | $30.20 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $64.57 / $131.83
| Facility | | $61.66 | $64.57 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $36.31 / $79.43
| Professional | | $28.84 | $36.31 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $51.29 / $72.44
| Facility | | $30.20 | $51.29 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $53.70 / $81.28
| Professional | | $38.90 | $53.70 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $33.11 / $34.67
| Facility | | $33.11 | $33.11 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $24.55 / $33.11
| Professional | | $24.55 | $24.55 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $33.11 / $33.11
| Facility | | $33.11 | $33.11 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $24.55 / $33.11
| Professional | | $24.55 | $24.55 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $18.20 / $26.30
| Professional | | $12.88 | $18.20 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $72.44 / $72.44
| Facility | | $72.44 | $72.44 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $67.61 / $125.89
| Professional | | $57.54 | $67.61 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $48.98 / $72.44
| Facility | | $20.42 | $48.98 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $28.18 / $40.74
| Professional | | $19.95 | $28.18 | $40.74 |