- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $53.70 / $213.80
| Facility | | $12.02 | $53.70 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $10.47 / $15.14
| Professional | | $7.76 | $10.47 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $8.32 / $16.60
| Professional | | $7.94 | $8.32 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $26.30 / $38.02
| Facility | | $21.38 | $26.30 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.76 / $10.72
| Professional | | $7.08 | $7.76 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $25.12 / $53.70
| Facility | | $8.13 | $25.12 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.32 / $18.20
| Professional | | $6.03 | $8.32 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $22.91 / $67.61
| Professional | | $9.77 | $22.91 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $10.72 / $22.91
| Facility | | $9.55 | $10.72 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $35.48 / $39.81
| Professional | | $9.55 | $35.48 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $436.52 / $436.52 / $741.31
| Facility | | $436.52 | $436.52 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $11.75 / $20.89
| Facility | | $6.17 | $11.75 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $8.32 / $16.60
| Professional | | $5.89 | $8.32 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $138.04 / $138.04 / $144.54
| Facility | | $138.04 | $138.04 | $144.54 |