- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $47.86 / $81.28
| Facility | | $27.54 | $47.86 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $21.88 / $39.81
| Professional | | $12.02 | $21.88 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $27.54 / $70.79
| Facility | | $27.54 | $27.54 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $46.77
| Professional | | $10.96 | $10.96 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $27.54 / $27.54
| Facility | | $16.22 | $27.54 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $27.54 / $27.54
| Professional | | $19.95 | $27.54 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $57.54 / $186.21
| Facility | | $26.92 | $57.54 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $33.11 / $131.83
| Professional | | $14.13 | $33.11 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $27.54 / $75.86
| Facility | | $12.02 | $27.54 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $19.05 / $52.48
| Professional | | $12.88 | $19.05 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $18.62
| Facility | | $18.62 | $18.62 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $22.91 / $28.84
| Professional | | $15.85 | $22.91 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $19.05
| Facility | | $19.05 | $19.05 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $48.98 / $50,118.72
| Facility | | $21.38 | $48.98 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $27.54 / $37.15
| Facility | | $16.22 | $27.54 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $16.22 / $60.26
| Professional | | $11.48 | $16.22 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $22.39 / $41.69
| Facility | | $18.62 | $22.39 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $23.99 / $54.95
| Professional | | $16.60 | $23.99 | $54.95 |