- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $52.48 / $91.20
| Facility | | $7.41 | $52.48 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $20.89 / $43.65
| Professional | | $1.00 | $20.89 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $77.62
| Facility | | $30.20 | $30.20 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $12.02 / $40.74
| Professional | | $2.29 | $12.02 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $30.20 / $30.20
| Facility | | $17.78 | $30.20 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $30.20 / $30.20
| Professional | | $21.88 | $30.20 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $64.57 / $77.62
| Facility | | $25.12 | $64.57 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $20.89 / $144.54
| Professional | | $2.09 | $20.89 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $30.20 / $67.61
| Facility | | $1.00 | $30.20 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $17.78 / $57.54
| Professional | | $2.88 | $17.78 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.04 / $2.04
| Facility | | $2.04 | $2.04 | $2.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.69 / $31.62
| Professional | | $2.04 | $2.69 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $53.70 / $50,118.72
| Facility | | $3.24 | $53.70 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $30.20 / $40.74
| Facility | | $3.47 | $30.20 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $17.78 / $47.86
| Professional | | $2.19 | $17.78 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.40 / $34.67
| Facility | | $2.04 | $2.40 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $6.17 / $33.88
| Professional | | $2.04 | $6.17 | $33.88 |