- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $58.88 / $120.23
| Facility | | $19.05 | $58.88 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.59 / $42.66
| Professional | | $8.91 | $12.59 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $33.88 / $34.67
| Facility | | $26.92 | $33.88 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $50.12
| Professional | | $8.13 | $8.13 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $13.18
| Facility | | $7.08 | $7.08 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $12.59
| Professional | | $12.59 | $12.59 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $39.81 / $64.57
| Facility | | $33.88 | $39.81 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $19.05 / $38.90
| Professional | | $14.45 | $19.05 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $25.12 / $87.10
| Facility | | $9.77 | $25.12 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $11.22 / $60.26
| Facility | | $9.77 | $11.22 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $8.91 / $24.55
| Professional | | $6.31 | $8.91 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $32.36 / $85.11
| Professional | | $12.59 | $32.36 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $15.14 / $19.50
| Facility | | $13.49 | $15.14 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $20.89 / $35.48
| Professional | | $9.33 | $20.89 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $30.20 / $44.67
| Professional | | $16.98 | $30.20 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $25.12 / $1,096.48
| Facility | | $25.12 | $25.12 | $1,096.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $6.92 / $30.90
| Professional | | $6.61 | $6.92 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $26.92
| Professional | | $11.22 | $11.22 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $36.31 / $69.18
| Professional | | $11.22 | $36.31 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $10.00 / $15.14
| Facility | | $6.31 | $10.00 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $8.91 / $26.30
| Professional | | $6.31 | $8.91 | $26.30 |