- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $54.95 / $141.25
| Facility | | $18.20 | $54.95 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.02 / $39.81
| Professional | | $10.00 | $12.02 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $8.13 / $13.49
| Professional | | $2.75 | $8.13 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $61.66 / $524.81
| Facility | | $23.44 | $61.66 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $8.91
| Professional | | $8.91 | $8.91 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $95.50 / $5,011.87
| Facility | | $72.44 | $95.50 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $12.88
| Professional | | $10.72 | $10.72 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $20.89 / $46.77
| Facility | | $9.77 | $20.89 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $16.98 / $33.11
| Professional | | $7.94 | $16.98 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $13.49 / $19.95
| Professional | | $6.46 | $13.49 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $26.30
| Facility | | $13.49 | $13.49 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $15.14 / $23.44
| Professional | | $13.18 | $15.14 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $38.02 / $89.13
| Facility | | $21.38 | $38.02 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $9.33 / $11.22
| Professional | | $8.13 | $9.33 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $61.66 / $524.81
| Facility | | $24.55 | $61.66 | $524.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $9.12
| Professional | | $8.91 | $8.91 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $28.84 / $72.44
| Facility | | $9.55 | $28.84 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.02 / $23.99
| Professional | | $10.00 | $12.02 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $354.81 / $416.87 / $776.25
| Facility | | $354.81 | $416.87 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $16.22 / $72.44
| Facility | | $12.02 | $16.22 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $13.49 / $72.44
| Professional | | $7.94 | $13.49 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $13.49 / $16.22
| Facility | | $7.59 | $13.49 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $9.12 / $23.99
| Professional | | $6.17 | $9.12 | $23.99 |