- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $47.86 / $81.28
| Facility | | $21.38 | $47.86 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $21.88 / $28.84
| Professional | | $18.20 | $21.88 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $11.22
| Professional | | $11.22 | $11.22 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $25.12 / $64.57
| Facility | | $25.12 | $25.12 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $15.14 / $57.54
| Professional | | $12.30 | $15.14 | $57.54 |
- 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
- $18.20 / $25.12 / $25.12
| Professional | | $18.20 | $25.12 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $54.95 / $269.15
| Facility | | $24.55 | $54.95 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $35.48 / $138.04
| Professional | | $16.98 | $35.48 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $32.36 / $89.13
| Facility | | $21.88 | $32.36 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $17.38 / $47.86
| Professional | | $11.75 | $17.38 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $25.12 / $25.12
| Facility | | $25.12 | $25.12 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $25.12 / $32.36
| Professional | | $21.38 | $25.12 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $30.90 / $112.20
| Facility | | $19.95 | $30.90 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $46.77 / $50,118.72
| Facility | | $29.51 | $46.77 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $30.20 / $40.74
| Facility | | $18.62 | $30.20 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $18.62 / $56.23
| Professional | | $10.47 | $18.62 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $25.12 / $57.54
| Facility | | $21.38 | $25.12 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $26.30 / $70.79
| Professional | | $21.38 | $26.30 | $70.79 |