- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $53.70 / $131.83
| Facility | | $16.22 | $53.70 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.00 / $69.18
| Professional | | $7.41 | $10.00 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $5.75
| Professional | | $5.75 | $5.75 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $26.92 / $57.54
| Facility | | $6.61 | $26.92 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $8.91 / $26.30
| Professional | | $5.75 | $8.91 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $66.07 / $147.91
| Facility | | $24.55 | $66.07 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.47 / $31.62
| Professional | | $7.41 | $10.47 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $20.42 / $42.66
| Facility | | $8.71 | $20.42 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $13.18 / $29.51
| Professional | | $6.76 | $13.18 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $11.48 / $18.62
| Professional | | $10.00 | $11.48 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $11.48 / $30.90
| Professional | | $9.12 | $11.48 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $100.00
| Facility | | $79.43 | $79.43 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $13.80
| Professional | | $6.92 | $6.92 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $13.80 / $31.62
| Facility | | $9.55 | $13.80 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $10.47 / $29.51
| Professional | | $6.76 | $10.47 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $40.74
| Professional | | $40.74 | $40.74 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $11.22 / $16.98
| Professional | | $9.12 | $11.22 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $7.94 / $11.48
| Facility | | $5.25 | $7.94 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $6.92 / $23.44
| Professional | | $4.79 | $6.92 | $23.44 |