- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $87.10 / $954.99
| Facility | | $10.00 | $87.10 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $8.51 / $19.95
| Professional | | $2.69 | $8.51 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $2.45 / $4.07
| Professional | | $2.45 | $2.45 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $24.55
| Facility | | $9.33 | $9.33 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.20 / $2.45 / $7.94
| Professional | | $1.20 | $2.45 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $4.27
| Facility | | $4.27 | $4.27 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $4.27 / $4.27
| Professional | | $1.51 | $4.27 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.07 / $19.95
| Facility | | $3.24 | $4.07 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $5.01 / $43.65
| Professional | | $3.16 | $5.01 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $9.33 / $20.89
| Facility | | $2.00 | $9.33 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $4.07 / $17.78
| Professional | | $2.51 | $4.07 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $9.12 / $9.55
| Professional | | $2.51 | $9.12 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $9.55 / $30.20
| Facility | | $2.40 | $9.55 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.04 / $21.38
| Professional | | $2.00 | $2.04 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $16.60 / $50,118.72
| Facility | | $11.48 | $16.60 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.63 / $11.22
| Facility | | $3.02 | $3.63 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $3.89 / $15.14
| Professional | | $1.26 | $3.89 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $7.59 / $11.75
| Professional | | $2.51 | $7.59 | $11.75 |