- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $36.31 / $44.67
| Facility | | $19.05 | $36.31 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $15.14 / $19.05
| Professional | | $12.02 | $15.14 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $43.65 / $44.67
| Facility | | $34.67 | $43.65 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $64.57
| Professional | | $7.94 | $7.94 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $8.91
| Facility | | $8.91 | $8.91 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $51.29 / $83.18
| Facility | | $43.65 | $51.29 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $23.44 / $50.12
| Professional | | $18.62 | $23.44 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $35.48 / $128.82
| Facility | | $14.45 | $35.48 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.14 / $114.82
| Facility | | $12.88 | $15.14 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $13.18 / $36.31
| Professional | | $9.55 | $13.18 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $32.36 / $64.57
| Professional | | $16.22 | $32.36 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $19.50 / $45.71
| Facility | | $19.50 | $19.50 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $26.30 / $45.71
| Professional | | $12.02 | $26.30 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $40.74 / $107.15
| Professional | | $21.38 | $40.74 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $33.11 / $114.82
| Facility | | $33.11 | $33.11 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.72 / $15.85
| Professional | | $8.51 | $10.72 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $29.51 / $34.67
| Professional | | $29.51 | $29.51 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $46.77 / $93.33
| Professional | | $29.51 | $46.77 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $14.45 / $19.50
| Facility | | $8.13 | $14.45 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $12.88 / $36.31
| Professional | | $6.76 | $12.88 | $36.31 |