- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $52.48
| Facility | | $11.22 | $11.22 | $52.48 |
- 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
- $8.32 / $8.32 / $8.32
| Professional | | $8.32 | $8.32 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.32 / $4.47 / $436.52
| Facility | | $1.32 | $4.47 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $23.99 / $32.36
| Professional | | $14.79 | $23.99 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $14.13
| Facility | | $14.13 | $14.13 | $14.13 |
- 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 / $23.99 / $41.69
| Professional | | $12.30 | $23.99 | $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
- $20.42 / $22.91 / $39.81
| Professional | | $20.42 | $22.91 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $22.91 / $39.81
| Facility | | $14.45 | $22.91 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $5.01 / $60,255.96
| Professional | | $2.45 | $5.01 | $60,255.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $18.20 / $18.20
| Professional | | $11.75 | $18.20 | $18.20 |
- 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
- $9.12 / $13.18 / $26.30
| Facility | | $9.12 | $13.18 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $10.23 / $23.99
| Professional | | $9.55 | $10.23 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $12.30 / $16.60
| Professional | | $8.32 | $12.30 | $16.60 |