- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $41.69 / $123.03
| Facility | | $16.98 | $41.69 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $16.98 / $25.12
| Professional | | $12.02 | $16.98 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $69.18 / $117.49
| Facility | | $24.55 | $69.18 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $12.30 / $21.38
| Professional | | $5.01 | $12.30 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $48.98 / $75.86
| Facility | | $48.98 | $48.98 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $22.39 / $33.88
| Professional | | $15.85 | $22.39 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $22.39 / $22.39
| Facility | | $12.02 | $22.39 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $44.67 / $114.82
| Facility | | $22.39 | $44.67 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $14.13 / $33.88
| Professional | | $11.75 | $14.13 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $147.91 / $147.91
| Facility | | $147.91 | $147.91 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $38.90 / $38.90
| Professional | | $38.90 | $38.90 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $22.39 / $83.18
| Facility | | $16.60 | $22.39 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $19.95 / $32.36
| Professional | | $12.88 | $19.95 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $18.62 / $18.62
| Professional | | $16.98 | $18.62 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $22.39 / $66.07
| Facility | | $16.22 | $22.39 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $14.13 / $32.36
| Professional | | $11.75 | $14.13 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $22.39 / $26.92
| Facility | | $9.33 | $22.39 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $11.22 / $17.78
| Professional | | $9.33 | $11.22 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $11.48 / $15.49
| Professional | | $8.71 | $11.48 | $15.49 |