- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $77.62 / $213.80
| Facility | | $25.12 | $77.62 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $12.59 / $57.54
| Professional | | $11.48 | $12.59 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $19.50 / $123.03
| Facility | | $12.88 | $19.50 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $17.38 / $41.69
| Professional | | $10.47 | $17.38 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $34.67 / $48.98
| Facility | | $27.54 | $34.67 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $123.03
| Professional | | $16.22 | $16.22 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $21.88 / $50.12
| Facility | | $12.02 | $21.88 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $19.95 / $44.67
| Professional | | $10.00 | $19.95 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $23.44 / $4,897.79
| Facility | | $17.78 | $23.44 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $22.39 / $28.84
| Professional | | $19.05 | $22.39 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $39.81
| Professional | | $17.38 | $17.38 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $30.20 / $346.74
| Facility | | $14.45 | $30.20 | $346.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $19.50 / $123.03
| Facility | | $12.88 | $19.50 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $17.38 / $41.69
| Professional | | $10.47 | $17.38 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $20.42 / $33.11
| Facility | | $13.49 | $20.42 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $15.14 / $25.70
| Professional | | $13.18 | $15.14 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $16.22 / $20.89
| Facility | | $7.76 | $16.22 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $13.49 / $50.12
| Professional | | $8.71 | $13.49 | $50.12 |