- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $50.12 / $72.44
| Facility | | $15.14 | $50.12 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $20.42 / $70.79
| Professional | | $15.14 | $20.42 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $25.70 / $107.15
| Facility | | $16.60 | $25.70 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $22.39 / $54.95
| Professional | | $7.76 | $22.39 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $44.67 / $64.57
| Facility | | $35.48 | $44.67 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $20.89 / $20.89
| Professional | | $5.50 | $20.89 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $30.90 / $63.10
| Facility | | $15.85 | $30.90 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $25.70 / $38.90
| Professional | | $12.59 | $25.70 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $29.51 / $4,897.79
| Facility | | $19.50 | $29.51 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $29.51 / $38.02
| Professional | | $24.55 | $29.51 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $22.39 / $52.48
| Professional | | $22.39 | $22.39 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $25.70 / $107.15
| Facility | | $16.60 | $25.70 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $22.39 / $54.95
| Professional | | $7.76 | $22.39 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $21.38 / $26.92
| Facility | | $6.76 | $21.38 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $22.39 / $54.95
| Professional | | $6.17 | $22.39 | $54.95 |