- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $51.29 / $112.20
| Facility | | $14.45 | $51.29 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $11.48 / $79.43
| Professional | | $10.00 | $11.48 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $12.88
| Professional | | $7.76 | $7.76 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $63.10 / $1,412.54
| Facility | | $19.95 | $63.10 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $91.20 / $5,011.87
| Facility | | $67.61 | $91.20 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $41.69
| Professional | | $10.00 | $10.00 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $19.50 / $43.65
| Facility | | $9.33 | $19.50 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $14.79 / $23.44
| Professional | | $7.59 | $14.79 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.59 / $18.62
| Professional | | $6.03 | $7.59 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $12.88 / $12.88
| Facility | | $12.88 | $12.88 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $14.45 / $22.39
| Professional | | $12.59 | $14.45 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $37.15 / $79.43
| Facility | | $24.55 | $37.15 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $8.51 / $10.72
| Professional | | $7.76 | $8.51 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $53.70 / $123.03
| Facility | | $14.79 | $53.70 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $19.50 / $56.23
| Facility | | $8.91 | $19.50 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $21.38
| Professional | | $8.91 | $10.96 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $69.18
| Facility | | $54.95 | $54.95 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $14.13 / $16.98
| Facility | | $11.48 | $14.13 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $14.13 / $16.98
| Professional | | $11.48 | $14.13 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $12.88 / $15.49
| Facility | | $7.59 | $12.88 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $12.88 / $21.88
| Professional | | $5.75 | $12.88 | $21.88 |