- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $44.67 / $87.10
| Facility | | $14.79 | $44.67 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.88 / $30.20
| Professional | | $10.96 | $12.88 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $26.92 / $2,570.40
| Facility | | $10.00 | $26.92 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $83.18 / $5,011.87
| Facility | | $63.10 | $83.18 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $13.49
| Professional | | $13.49 | $13.49 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $22.39 / $51.29
| Facility | | $12.02 | $22.39 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $15.85 / $25.70
| Professional | | $7.94 | $15.85 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $10.23 / $25.12
| Professional | | $8.13 | $10.23 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $17.38
| Facility | | $17.38 | $17.38 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.79 / $30.20
| Professional | | $12.02 | $14.79 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $42.66 / $141.25
| Facility | | $22.39 | $42.66 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $10.47 / $28.18
| Professional | | $10.47 | $10.47 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $22.91 / $53.70
| Facility | | $10.00 | $22.91 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $26.30 / $50.12
| Facility | | $12.02 | $26.30 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.88 / $20.89
| Professional | | $10.96 | $12.88 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $14.45 / $26.30
| Facility | | $13.18 | $14.45 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $14.45 / $26.30
| Professional | | $13.18 | $14.45 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $17.38 / $20.89
| Facility | | $8.32 | $17.38 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $10.47 / $25.70
| Professional | | $7.24 | $10.47 | $25.70 |