- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $41.69 / $95.50
| Facility | | $14.45 | $41.69 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $11.75 / $23.44
| Professional | | $10.00 | $11.75 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $18.20 / $79.43
| Facility | | $11.75 | $18.20 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $14.45 / $34.67
| Professional | | $8.51 | $14.45 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $31.62 / $45.71
| Facility | | $25.12 | $31.62 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $20.42 / $50.12
| Facility | | $10.47 | $20.42 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $16.60 / $37.15
| Professional | | $8.71 | $16.60 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $104.71 / $7,079.46
| Facility | | $14.79 | $104.71 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $23.99
| Professional | | $20.42 | $20.42 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $35.48
| Professional | | $14.45 | $14.45 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $19.05 / $85.11
| Facility | | $14.45 | $19.05 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $18.20 / $79.43
| Facility | | $11.75 | $18.20 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $14.45 / $34.67
| Professional | | $8.51 | $14.45 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $19.95 / $33.11
| Facility | | $13.18 | $19.95 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $13.80 / $21.38
| Professional | | $12.59 | $13.80 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $14.45 / $19.05
| Facility | | $7.08 | $14.45 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $11.48 / $35.48
| Professional | | $8.51 | $11.48 | $35.48 |