- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $169.82 / $2,290.87
| Facility | | $23.44 | $169.82 | $2,290.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $20.42 / $58.88
| Professional | | $9.55 | $20.42 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $10.72 / $17.38
| Professional | | $9.33 | $10.72 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $1,778.28 / $3,981.07
| Facility | | $676.08 | $1,778.28 | $3,981.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $18.62 / $30.90
| Professional | | $13.18 | $18.62 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $14.45 / $22.91
| Professional | | $12.30 | $14.45 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $18.20
| Facility | | $18.20 | $18.20 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $23.99 / $61.66
| Professional | | $10.72 | $23.99 | $61.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $22.91 / $912.01
| Facility | | $10.23 | $22.91 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $20.42 / $812.83
| Professional | | $10.47 | $20.42 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $537.03 / $1,412.54
| Facility | | $46.77 | $537.03 | $1,412.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $15.85 / $28.84
| Professional | | $10.23 | $15.85 | $28.84 |