- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $50.12 / $436.52
| Facility | | $12.88 | $50.12 | $436.52 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $16.22 / $34.67
| Professional | | $10.00 | $16.22 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $10.72 / $17.38
| Professional | | $6.03 | $10.72 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $51.29 / $91.20
| Facility | | $18.62 | $51.29 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $9.55 / $17.38
| Professional | | $5.01 | $9.55 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $25.70 / $58.88
| Facility | | $15.85 | $25.70 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $13.80 / $27.54
| Professional | | $10.47 | $13.80 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $23.99 / $23.99
| Facility | | $23.99 | $23.99 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $25.12 / $77.62
| Facility | | $11.22 | $25.12 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $9.77 / $26.30
| Professional | | $7.08 | $9.77 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $81.28 / $81.28
| Facility | | $81.28 | $81.28 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $16.22 / $28.18
| Professional | | $14.45 | $16.22 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $17.38 / $87.10
| Facility | | $12.59 | $17.38 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.49 / $27.54
| Professional | | $10.00 | $15.49 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $12.88 / $14.45
| Professional | | $12.88 | $12.88 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $346.74 / $380.19
| Facility | | $165.96 | $346.74 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $17.38 / $42.66
| Facility | | $12.30 | $17.38 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $9.12 / $22.39
| Professional | | $7.08 | $9.12 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $17.38 / $20.89
| Facility | | $7.24 | $17.38 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $12.02
| Professional | | $7.24 | $7.24 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $8.91 / $17.38
| Professional | | $6.76 | $8.91 | $17.38 |