- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $63.10 / $138.04
| Facility | | $26.92 | $63.10 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $20.42 / $89.13
| Professional | | $16.98 | $20.42 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $61.66 / $63.10
| Facility | | $48.98 | $61.66 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $91.20
| Professional | | $11.22 | $11.22 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $15.49
| Facility | | $15.49 | $15.49 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $74.13 / $117.49
| Facility | | $63.10 | $74.13 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $33.11 / $70.79
| Professional | | $26.30 | $33.11 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $50.12 / $181.97
| Facility | | $20.42 | $50.12 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $21.38 / $64.57
| Facility | | $18.20 | $21.38 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $18.62 / $51.29
| Professional | | $13.80 | $18.62 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $33.11 / $81.28
| Professional | | $11.48 | $33.11 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $27.54 / $64.57
| Facility | | $27.54 | $27.54 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $37.15 / $64.57
| Professional | | $16.98 | $37.15 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $57.54 / $123.03
| Professional | | $30.20 | $57.54 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $45.71 / $173.78
| Facility | | $45.71 | $45.71 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $15.14 / $22.39
| Professional | | $12.02 | $15.14 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $48.98 / $67.61
| Professional | | $48.98 | $48.98 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $67.61 / $138.04
| Professional | | $67.61 | $67.61 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $20.42 / $27.54
| Facility | | $11.48 | $20.42 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $18.20 / $51.29
| Professional | | $11.48 | $18.20 | $51.29 |