- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $47.86 / $79.43
| Facility | | $26.30 | $47.86 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $20.89 / $38.90
| Professional | | $10.00 | $20.89 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $26.30 / $69.18
| Facility | | $26.30 | $26.30 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $13.18 / $44.67
| Professional | | $12.59 | $13.18 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $26.30 / $26.30
| Facility | | $15.85 | $26.30 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $26.30 / $26.30
| Professional | | $19.50 | $26.30 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $57.54 / $151.36
| Facility | | $25.70 | $57.54 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $38.02 / $177.83
| Professional | | $17.78 | $38.02 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $30.90 / $63.10
| Facility | | $15.49 | $30.90 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $18.62 / $51.29
| Professional | | $12.59 | $18.62 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $16.60
| Facility | | $16.60 | $16.60 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $25.12 / $36.31
| Professional | | $16.60 | $25.12 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $47.86 / $50,118.72
| Facility | | $26.30 | $47.86 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $32.36 / $43.65
| Facility | | $19.50 | $32.36 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $15.85 / $60.26
| Professional | | $11.22 | $15.85 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $19.50 / $72.44
| Facility | | $16.60 | $19.50 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $26.30 / $97.72
| Professional | | $16.60 | $26.30 | $97.72 |