- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $67.61 / $199.53
| Facility | | $24.55 | $67.61 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.14 / $25.70
| Professional | | $12.88 | $15.14 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $23.99 / $346.74
| Facility | | $15.49 | $23.99 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $17.78 / $52.48
| Professional | | $10.72 | $17.78 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $41.69 / $60.26
| Facility | | $33.11 | $41.69 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $26.92 / $64.57
| Facility | | $13.49 | $26.92 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $20.42 / $46.77
| Professional | | $10.96 | $20.42 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $134.90 / $7,079.46
| Facility | | $19.50 | $134.90 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $30.20
| Professional | | $25.70 | $25.70 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $51.29
| Professional | | $17.78 | $17.78 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $26.92 / $93.33
| Facility | | $15.14 | $26.92 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $23.99 / $346.74
| Facility | | $15.49 | $23.99 | $346.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $17.78 / $52.48
| Professional | | $10.72 | $17.78 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $19.95 / $30.90
| Facility | | $17.38 | $19.95 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $17.38 / $26.92
| Professional | | $15.85 | $17.38 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $17.78 / $24.55
| Facility | | $9.55 | $17.78 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $17.78 / $54.95
| Professional | | $10.72 | $17.78 | $54.95 |