- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $50.12 / $109.65
| Facility | | $18.20 | $50.12 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.88 / $89.13
| Professional | | $10.96 | $12.88 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $8.91 / $23.44
| Professional | | $7.24 | $8.91 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $72.44 / $213.80
| Facility | | $25.12 | $72.44 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $102.33 / $5,011.87
| Facility | | $77.62 | $102.33 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $13.80
| Professional | | $11.48 | $11.48 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $22.39 / $50.12
| Facility | | $10.47 | $22.39 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $19.05 / $35.48
| Professional | | $8.71 | $19.05 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $8.71 / $20.89
| Professional | | $6.92 | $8.71 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $14.45
| Facility | | $14.45 | $14.45 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $16.22 / $25.12
| Professional | | $14.13 | $16.22 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $38.90 / $91.20
| Facility | | $23.99 | $38.90 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $9.55 / $10.96
| Professional | | $8.71 | $9.55 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $69.18 / $213.80
| Facility | | $16.60 | $69.18 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $21.88 / $46.77
| Facility | | $10.23 | $21.88 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.02 / $22.39
| Professional | | $10.00 | $12.02 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $158.49 / $158.49 / $158.49
| Facility | | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $14.45 / $95.50
| Facility | | $13.18 | $14.45 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $13.18 / $95.50
| Professional | | $12.88 | $13.18 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $14.45 / $17.38
| Facility | | $7.94 | $14.45 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $9.55 / $25.12
| Professional | | $6.61 | $9.55 | $25.12 |