- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $67.61 / $416.87
| Facility | | $10.47 | $67.61 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.00 / $41.69
| Professional | | $7.08 | $10.00 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.50 / $11.48
| Professional | | $4.07 | $5.50 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $35.48 / $67.61
| Facility | | $12.59 | $35.48 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.31 / $9.12
| Professional | | $5.01 | $6.31 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $17.78 / $75.86
| Facility | | $10.72 | $17.78 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $12.02 / $19.50
| Professional | | $8.13 | $12.02 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $11.48
| Facility | | $11.48 | $11.48 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $25.70 / $61.66
| Facility | | $13.49 | $25.70 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $12.02 / $19.50
| Professional | | $7.24 | $12.02 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $97.72 / $97.72 / $97.72
| Facility | | $97.72 | $97.72 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $16.98 / $19.50
| Professional | | $10.47 | $16.98 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $19.05 / $204.17
| Facility | | $8.71 | $19.05 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $10.47 / $30.90
| Professional | | $6.92 | $10.47 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $9.77 / $9.77
| Professional | | $8.71 | $9.77 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $288.40 / $478.63 / $512.86
| Facility | | $288.40 | $478.63 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $11.48 / $33.88
| Facility | | $9.12 | $11.48 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $11.48 / $19.50
| Professional | | $7.08 | $11.48 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $11.48 / $13.80
| Facility | | $5.25 | $11.48 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $6.76 / $12.59
| Professional | | $4.79 | $6.76 | $12.59 |