- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $218.78 / $758.58
| Facility | | $24.55 | $218.78 | $758.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $9.12 / $27.54
| Professional | | $7.08 | $9.12 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.59 / $7.76
| Professional | | $6.03 | $7.59 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $36.31 / $66.07
| Facility | | $13.49 | $36.31 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.92 / $10.00
| Professional | | $5.01 | $6.92 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $20.42 / $70.79
| Facility | | $11.48 | $20.42 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $13.18 / $21.38
| Professional | | $8.71 | $13.18 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $54.95 / $54.95
| Facility | | $12.59 | $54.95 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $23.44 / $58.88
| Facility | | $11.48 | $23.44 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $9.77 / $21.38
| Professional | | $6.46 | $9.77 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $91.20 / $91.20
| Facility | | $91.20 | $91.20 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $15.85 / $22.39
| Professional | | $10.72 | $15.85 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $138.04 / $645.65
| Facility | | $9.55 | $138.04 | $645.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.96 / $21.38
| Professional | | $7.08 | $10.96 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $10.47 / $10.47
| Professional | | $9.33 | $10.47 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,348.96 / $3,311.31 / $3,311.31
| Facility | | $1,348.96 | $3,311.31 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $12.59 / $36.31
| Facility | | $9.12 | $12.59 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $9.77 / $21.38
| Professional | | $6.46 | $9.77 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $12.59 / $14.79
| Facility | | $5.25 | $12.59 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.75 / $15.14
| Professional | | $5.25 | $5.75 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $6.46 / $8.51
| Professional | | $4.90 | $6.46 | $8.51 |