- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $48.98 / $281.84
| Facility | | $9.33 | $48.98 | $281.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $10.23 / $21.88
| Professional | | $7.59 | $10.23 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.59 / $18.62
| Professional | | $10.23 | $12.59 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $37.15 / $67.61
| Facility | | $13.49 | $37.15 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.92 / $8.71
| Professional | | $5.01 | $6.92 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $19.95 / $204.17
| Facility | | $11.22 | $19.95 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.59 / $19.95
| Professional | | $8.91 | $12.59 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $13.18 / $13.18
| Facility | | $12.59 | $13.18 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $27.54 / $56.23
| Facility | | $13.49 | $27.54 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $11.48 / $20.89
| Professional | | $6.61 | $11.48 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,096.48 / $1,096.48 / $1,096.48
| Facility | | $1,096.48 | $1,096.48 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $14.13 / $21.88
| Professional | | $10.72 | $14.13 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $13.80 / $194.98
| Facility | | $9.12 | $13.80 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.72 / $21.88
| Professional | | $7.08 | $10.72 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $10.47 / $10.47
| Professional | | $9.33 | $10.47 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $12.59 / $35.48
| Facility | | $9.12 | $12.59 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $10.23 / $19.05
| Professional | | $6.61 | $10.23 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $12.59 / $15.14
| Facility | | $5.25 | $12.59 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $6.31 / $10.47
| Professional | | $5.25 | $6.31 | $10.47 |