- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $48.98 / $97.72
| Facility | | $18.20 | $48.98 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $64.57
| Professional | | $7.94 | $10.00 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $30.90 / $67.61
| Facility | | $6.17 | $30.90 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $9.77 / $29.51
| Professional | | $5.37 | $9.77 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $61.66 / $138.04
| Facility | | $22.91 | $61.66 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $9.77 / $33.11
| Professional | | $6.92 | $9.77 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $23.44 / $45.71
| Facility | | $9.33 | $23.44 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $10.96 / $25.12
| Professional | | $6.46 | $10.96 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $13.49 / $21.38
| Professional | | $9.33 | $13.49 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $13.49 / $30.20
| Professional | | $10.72 | $13.49 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $70.79 / $100.00
| Facility | | $70.79 | $70.79 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $6.61 / $13.49
| Professional | | $6.61 | $6.61 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $14.45 / $33.88
| Facility | | $9.77 | $14.45 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $9.33 / $26.92
| Professional | | $6.46 | $9.33 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $46.77 / $46.77
| Professional | | $46.77 | $46.77 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $13.49 / $22.91
| Professional | | $10.72 | $13.49 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $7.94 / $13.49
| Facility | | $5.89 | $7.94 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.94 / $25.12
| Professional | | $5.01 | $7.94 | $25.12 |