- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $50.12 / $89.13
| Facility | | $21.38 | $50.12 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $22.39 / $30.20
| Professional | | $18.20 | $22.39 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $25.12 / $66.07
| Facility | | $25.12 | $25.12 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $13.18 / $58.88
| Professional | | $12.59 | $13.18 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $25.12 / $25.12
| Facility | | $15.14 | $25.12 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $25.12 / $25.12
| Professional | | $18.62 | $25.12 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $54.95 / $275.42
| Facility | | $24.55 | $54.95 | $275.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $36.31 / $165.96
| Professional | | $16.98 | $36.31 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $30.20 / $75.86
| Facility | | $18.62 | $30.20 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $17.78 / $48.98
| Professional | | $11.75 | $17.78 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $23.99 / $23.99
| Facility | | $23.99 | $23.99 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $25.12 / $33.88
| Professional | | $22.39 | $25.12 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $30.90 / $114.82
| Facility | | $19.05 | $30.90 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $47.86 / $50,118.72
| Facility | | $30.90 | $47.86 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $30.90 / $41.69
| Facility | | $19.05 | $30.90 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $19.95 / $57.54
| Professional | | $10.72 | $19.95 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $23.99 / $61.66
| Facility | | $21.38 | $23.99 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $26.30 / $87.10
| Professional | | $21.38 | $26.30 | $87.10 |