- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $52.48 / $213.80
| Facility | | $7.41 | $52.48 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $19.05
| Professional | | $19.05 | $19.05 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $8.32 / $38.90
| Professional | | $3.24 | $8.32 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $13.49 / $29.51
| Facility | | $4.07 | $13.49 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $21.88 / $138.04
| Facility | | $14.13 | $21.88 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $22.91
| Professional | | $13.18 | $13.18 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $77.62 / $77.62
| Facility | | $77.62 | $77.62 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.70 / $95.50 / $128.82
| Facility | | $1.70 | $95.50 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $19.50 / $41.69
| Professional | | $12.30 | $19.50 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $38.90 / $38.90
| Professional | | $38.90 | $38.90 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $23.99 / $125.89
| Facility | | $17.38 | $23.99 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $15.49 / $60,255.96
| Professional | | $5.01 | $15.49 | $60,255.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $9.33 / $9.33
| Professional | | $6.17 | $9.33 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $23.99 / $128.82
| Facility | | $2.00 | $23.99 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $21.38 / $43.65
| Professional | | $12.30 | $21.38 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.72 / $28.18
| Facility | | $8.91 | $10.72 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $10.23 / $15.49
| Professional | | $5.89 | $10.23 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.47 / $16.60
| Professional | | $4.37 | $4.47 | $16.60 |