- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $56.23 / $112.20
| Facility | | $20.89 | $56.23 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $75.86
| Professional | | $7.94 | $10.96 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $30.90 / $66.07
| Facility | | $6.17 | $30.90 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $9.77 / $33.88
| Professional | | $5.37 | $9.77 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $72.44 / $158.49
| Facility | | $26.92 | $72.44 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $11.48 / $35.48
| Professional | | $7.94 | $11.48 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $23.44 / $44.67
| Facility | | $9.33 | $23.44 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $13.18 / $26.92
| Professional | | $7.08 | $13.18 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $13.49 / $21.38
| Professional | | $10.72 | $13.49 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $13.49 / $30.20
| Professional | | $10.72 | $13.49 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $66.07 / $66.07
| Facility | | $66.07 | $66.07 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $6.61 / $13.49
| Professional | | $6.61 | $6.61 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $15.49 / $35.48
| Facility | | $6.61 | $15.49 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.23 / $26.92
| Professional | | $7.08 | $10.23 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $46.77 / $46.77
| Professional | | $46.77 | $46.77 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $13.49 / $22.91
| Professional | | $10.72 | $13.49 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.94 / $13.49
| Facility | | $6.03 | $7.94 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $6.03 / $25.12
| Professional | | $5.62 | $6.03 | $25.12 |