- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $52.48 / $7,413.10
| Facility | | $18.20 | $52.48 | $7,413.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.85 / $48.98
| Professional | | $12.88 | $15.85 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $46.77
| Facility | | $18.20 | $18.20 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $9.33 / $41.69
| Professional | | $8.91 | $9.33 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $18.20 / $18.20
| Facility | | $10.72 | $18.20 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $18.20 / $18.20
| Professional | | $13.18 | $18.20 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $39.81 / $194.98
| Facility | | $17.38 | $39.81 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $25.70 / $120.23
| Professional | | $12.02 | $25.70 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $20.89 / $48.98
| Facility | | $11.48 | $20.89 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $12.59 / $34.67
| Professional | | $8.51 | $12.59 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $18.20
| Facility | | $18.20 | $18.20 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $18.20 / $28.84
| Professional | | $15.49 | $18.20 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $83.18 / $83.18
| Facility | | $83.18 | $83.18 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $33.88 / $50,118.72
| Facility | | $21.88 | $33.88 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $21.88 / $29.51
| Facility | | $13.49 | $21.88 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $13.80 / $40.74
| Professional | | $7.59 | $13.80 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $18.20 / $42.66
| Facility | | $15.14 | $18.20 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $19.05 / $64.57
| Professional | | $15.14 | $19.05 | $64.57 |