- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $144.54 / $489.78
| Facility | | $38.90 | $144.54 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $12.59 / $58.88
| Professional | | $11.48 | $12.59 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $46.77 / $47.86
| Facility | | $37.15 | $46.77 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $64.57
| Professional | | $6.92 | $6.92 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $18.20
| Facility | | $11.48 | $11.48 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $17.38
| Professional | | $17.38 | $17.38 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $56.23 / $89.13
| Facility | | $47.86 | $56.23 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $24.55 / $53.70
| Professional | | $19.95 | $24.55 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $34.67 / $102.33
| Facility | | $11.48 | $34.67 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $74.13 / $165.96
| Facility | | $11.48 | $74.13 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $10.96 / $53.70
| Professional | | $9.55 | $10.96 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $32.36 / $64.57
| Professional | | $17.38 | $32.36 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $20.89 / $37.15
| Facility | | $19.95 | $20.89 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $25.12 / $48.98
| Professional | | $12.88 | $25.12 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $44.67 / $109.65
| Professional | | $22.91 | $44.67 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $34.67 / $123.03
| Facility | | $34.67 | $34.67 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.71 / $12.59
| Professional | | $8.51 | $8.71 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $37.15 / $70.79
| Professional | | $37.15 | $37.15 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $70.79 / $93.33
| Professional | | $50.12 | $70.79 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $13.80 / $20.89
| Facility | | $8.71 | $13.80 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $10.96 / $33.11
| Professional | | $7.59 | $10.96 | $33.11 |