- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $46.77 / $79.43
| Facility | | $19.95 | $46.77 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $18.20 / $46.77
| Professional | | $12.88 | $18.20 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $22.39 / $57.54
| Facility | | $22.39 | $22.39 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $45.71
| Professional | | $8.91 | $10.96 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $22.39 / $22.39
| Facility | | $13.18 | $22.39 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $22.39 / $22.39
| Professional | | $16.22 | $22.39 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $47.86 / $194.98
| Facility | | $21.38 | $47.86 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $26.92 / $120.23
| Professional | | $13.49 | $26.92 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $25.70 / $61.66
| Facility | | $13.18 | $25.70 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $15.49 / $42.66
| Professional | | $10.47 | $15.49 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $21.38 / $26.92
| Professional | | $16.98 | $21.38 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $43.65 / $436.52
| Facility | | $14.79 | $43.65 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $41.69 / $50,118.72
| Facility | | $22.39 | $41.69 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $26.30 / $30.20
| Facility | | $14.45 | $26.30 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $14.45 / $50.12
| Professional | | $9.33 | $14.45 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $25.70 / $66.07
| Facility | | $15.49 | $25.70 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $22.39 / $67.61
| Professional | | $16.98 | $22.39 | $67.61 |