- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $186.21 / $741.31
| Facility | | $28.84 | $186.21 | $741.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $9.12 / $35.48
| Professional | | $7.94 | $9.12 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $7.41 / $7.59
| Professional | | $6.76 | $7.41 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.59 / $14.79
| Facility | | $10.96 | $12.59 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.59 / $14.45
| Professional | | $10.23 | $12.59 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $12.02 / $32.36
| Facility | | $8.13 | $12.02 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $11.22 / $21.38
| Professional | | $6.31 | $11.22 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $10.23 / $10.23
| Facility | | $7.59 | $10.23 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $13.80
| Professional | | $7.41 | $7.41 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $6.03 / $7.41
| Professional | | $1.51 | $6.03 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $8.13 / $12.59
| Facility | | $5.01 | $8.13 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.03 / $34.67
| Professional | | $4.68 | $6.03 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $12.59
| Professional | | $7.41 | $7.41 | $12.59 |