- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $61.66 / $72.44
| Facility | | $25.70 | $61.66 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $20.89 / $77.62
| Professional | | $15.14 | $20.89 | $77.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $60.26 / $61.66
| Facility | | $47.86 | $60.26 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $83.18
| Professional | | $8.91 | $8.91 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $23.44
| Facility | | $15.14 | $15.14 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $22.39 / $22.39
| Professional | | $22.39 | $22.39 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $72.44 / $114.82
| Facility | | $61.66 | $72.44 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $32.36 / $70.79
| Professional | | $25.70 | $32.36 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $44.67 / $131.83
| Facility | | $11.22 | $44.67 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $20.42 / $107.15
| Facility | | $11.22 | $20.42 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $22.91 / $42.66
| Professional | | $13.49 | $22.91 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $33.88 / $64.57
| Professional | | $22.39 | $33.88 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $26.92 / $46.77
| Facility | | $25.70 | $26.92 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $31.62 / $63.10
| Professional | | $16.98 | $31.62 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $52.48 / $75.86
| Professional | | $29.51 | $52.48 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $107.15
| Facility | | $44.67 | $44.67 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $11.22
| Professional | | $10.96 | $10.96 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $47.86
| Professional | | $16.98 | $16.98 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $66.07 / $123.03
| Professional | | $16.98 | $66.07 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $17.78 / $26.92
| Facility | | $11.22 | $17.78 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $22.39 / $40.74
| Professional | | $13.49 | $22.39 | $40.74 |