- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $63.10 / $154.88
| Facility | | $20.42 | $63.10 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $14.13 / $56.23
| Professional | | $10.96 | $14.13 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $9.77 / $26.30
| Professional | | $9.55 | $9.77 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $87.10 / $269.15
| Facility | | $30.20 | $87.10 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $112.20 / $5,011.87
| Facility | | $85.11 | $112.20 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $15.14
| Professional | | $12.59 | $12.59 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $24.55 / $54.95
| Facility | | $11.48 | $24.55 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $20.89 / $38.90
| Professional | | $9.33 | $20.89 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $9.55 / $23.44
| Professional | | $7.59 | $9.55 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $16.22
| Facility | | $16.22 | $16.22 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $17.78 / $27.54
| Professional | | $15.85 | $17.78 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $40.74 / $93.33
| Facility | | $23.99 | $40.74 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $9.55 / $13.80
| Professional | | $9.55 | $9.55 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $83.18 / $338.84
| Facility | | $18.62 | $83.18 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $23.99 / $74.13
| Facility | | $11.22 | $23.99 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.88 / $24.55
| Professional | | $10.96 | $12.88 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $186.21 / $190.55 / $354.81
| Facility | | $186.21 | $190.55 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $14.79 / $16.22
| Facility | | $14.79 | $14.79 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $14.79 / $23.99
| Professional | | $3.24 | $14.79 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $16.22 / $19.05
| Facility | | $9.33 | $16.22 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $10.47 / $28.18
| Professional | | $6.76 | $10.47 | $28.18 |