- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $28.18 / $60.26
| Facility | | $11.75 | $28.18 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.30 / $19.95
| Professional | | $10.00 | $12.30 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $3.72 / $3.72
| Professional | | $3.72 | $3.72 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $35.48
| Facility | | $13.80 | $13.80 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $7.08 / $31.62
| Professional | | $6.76 | $7.08 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $13.80 / $13.80
| Facility | | $8.32 | $13.80 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $13.80 / $13.80
| Professional | | $10.00 | $13.80 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $30.20 / $147.91
| Facility | | $13.49 | $30.20 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $19.50 / $91.20
| Professional | | $9.12 | $19.50 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $17.78 / $48.98
| Facility | | $12.02 | $17.78 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $9.55 / $26.92
| Professional | | $6.46 | $9.55 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $13.80
| Facility | | $13.80 | $13.80 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $13.80 / $20.89
| Professional | | $12.02 | $13.80 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $28.84 / $213.80
| Facility | | $10.00 | $28.84 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $25.70 / $50,118.72
| Facility | | $16.98 | $25.70 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $16.60 / $22.39
| Facility | | $10.23 | $16.60 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $9.77 / $30.90
| Professional | | $5.75 | $9.77 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $13.80 / $33.11
| Facility | | $11.75 | $13.80 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $14.45 / $40.74
| Professional | | $11.75 | $14.45 | $40.74 |