- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $66.07 / $204.17
| Facility | | $21.38 | $66.07 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $15.14 / $33.88
| Professional | | $11.75 | $15.14 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $10.23 / $16.98
| Professional | | $3.39 | $10.23 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $75.86 / $512.86
| Facility | | $26.30 | $75.86 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $10.96
| Professional | | $10.96 | $10.96 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $120.23 / $5,011.87
| Facility | | $89.13 | $120.23 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $16.22
| Professional | | $13.18 | $13.18 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $25.70 / $57.54
| Facility | | $12.30 | $25.70 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $21.38 / $40.74
| Professional | | $10.00 | $21.38 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $24.55
| Professional | | $7.94 | $10.00 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $16.98
| Facility | | $16.98 | $16.98 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $19.05 / $29.51
| Professional | | $16.60 | $19.05 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $44.67 / $95.50
| Facility | | $24.55 | $44.67 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $13.18
| Professional | | $10.23 | $10.23 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $74.13 / $512.86
| Facility | | $19.50 | $74.13 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $11.48
| Professional | | $10.96 | $10.96 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $28.84 / $89.13
| Facility | | $11.75 | $28.84 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $14.79 / $26.92
| Professional | | $10.96 | $14.79 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $478.63 / $660.69
| Facility | | $177.83 | $478.63 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $15.49 / $18.20
| Facility | | $10.72 | $15.49 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $15.49 / $18.20
| Professional | | $10.72 | $15.49 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $16.98 / $20.42
| Facility | | $10.00 | $16.98 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $11.22 / $29.51
| Professional | | $7.59 | $11.22 | $29.51 |