- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $79.43 / $173.78
| Facility | | $20.42 | $79.43 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $12.02 / $38.02
| Professional | | $7.08 | $12.02 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $18.62 / $63.10
| Facility | | $12.02 | $18.62 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $13.18 / $32.36
| Professional | | $7.94 | $13.18 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $32.36 / $46.77
| Facility | | $25.70 | $32.36 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $16.98
| Professional | | $12.59 | $12.59 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $16.98 / $26.30
| Facility | | $9.55 | $16.98 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $15.14 / $34.67
| Professional | | $7.94 | $15.14 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $104.71 / $8,511.38
| Facility | | $19.05 | $104.71 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $36.31
| Professional | | $13.18 | $13.18 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $17.38 / $131.83
| Facility | | $15.49 | $17.38 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $18.62 / $63.10
| Facility | | $12.02 | $18.62 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $13.18 / $32.36
| Professional | | $7.94 | $13.18 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $15.85 / $21.38
| Facility | | $11.75 | $15.85 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $13.49 / $19.95
| Professional | | $11.75 | $13.49 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $13.18 / $18.20
| Facility | | $6.61 | $13.18 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $13.18 / $36.31
| Professional | | $7.94 | $13.18 | $36.31 |