- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $57.54 / $61.66
| Facility | | $25.12 | $57.54 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $25.12 / $25.12
| Professional | | $25.12 | $25.12 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $27.54 / $48.98
| Professional | | $26.92 | $27.54 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $50,118.72 / $53,703.18
| Facility | | $64.57 | $50,118.72 | $53,703.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $8.13
| Professional | | $8.13 | $8.13 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $20.42 / $23.99
| Professional | | $16.22 | $20.42 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $21.38
| Facility | | $20.42 | $20.42 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $22.91 / $22.91
| Professional | | $20.42 | $22.91 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $47.86
| Professional | | $16.22 | $16.22 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $50,118.72 / $75,857.76
| Facility | | $43.65 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $18.62
| Facility | | $18.62 | $18.62 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $28.18 / $64.57
| Professional | | $15.85 | $28.18 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $22.91 / $23.99
| Facility | | $20.42 | $22.91 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $22.91 / $22.91
| Professional | | $20.42 | $22.91 | $22.91 |