- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $42.66 / $61.66
| Facility | | $15.85 | $42.66 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $18.20 / $33.11
| Professional | | $3.98 | $18.20 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $22.39 / $58.88
| Facility | | $22.39 | $22.39 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $9.55 / $32.36
| Professional | | $4.90 | $9.55 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $22.39 / $22.39
| Facility | | $13.49 | $22.39 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $22.39 / $22.39
| Professional | | $16.22 | $22.39 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $47.86 / $63.10
| Facility | | $21.88 | $47.86 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $28.84 / $128.82
| Professional | | $13.49 | $28.84 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $25.70 / $61.66
| Facility | | $15.14 | $25.70 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $15.85 / $43.65
| Professional | | $8.91 | $15.85 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $6.31 / $6.31
| Facility | | $6.31 | $6.31 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $19.05 / $26.92
| Professional | | $6.31 | $19.05 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $77.62 / $77.62
| Facility | | $77.62 | $77.62 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $40.74 / $50,118.72
| Facility | | $13.49 | $40.74 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $26.92 / $31.62
| Facility | | $14.45 | $26.92 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $13.49 / $50.12
| Professional | | $8.13 | $13.49 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $9.55 / $46.77
| Facility | | $6.31 | $9.55 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $22.39 / $61.66
| Professional | | $6.31 | $22.39 | $61.66 |