- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $44.67 / $95.50
| Facility | | $14.13 | $44.67 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $93.33
| Professional | | $8.91 | $10.96 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $33.11 / $70.79
| Facility | | $6.61 | $33.11 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $10.47 / $31.62
| Professional | | $5.62 | $10.47 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $61.66 / $134.90
| Facility | | $22.91 | $61.66 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $9.77 / $33.11
| Professional | | $6.76 | $9.77 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $25.12 / $47.86
| Facility | | $9.55 | $25.12 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $10.96 / $26.30
| Professional | | $6.46 | $10.96 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $14.13 / $22.39
| Professional | | $9.33 | $14.13 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $14.13 / $32.36
| Professional | | $11.22 | $14.13 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $70.79 / $100.00
| Facility | | $70.79 | $70.79 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $14.13
| Professional | | $7.08 | $7.08 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $14.45 / $35.48
| Facility | | $10.00 | $14.45 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $9.55 / $28.18
| Professional | | $6.46 | $9.55 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $50.12
| Professional | | $50.12 | $50.12 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $14.45 / $23.99
| Professional | | $11.22 | $14.45 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $8.51 / $14.13
| Facility | | $5.89 | $8.51 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.31 / $26.92
| Professional | | $5.01 | $6.31 | $26.92 |