- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $144.54 / $338.84
| Facility | | $15.14 | $144.54 | $338.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.91 / $19.50
| Professional | | $6.03 | $8.91 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $5.13 / $7.08
| Professional | | $4.90 | $5.13 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $30.90 / $57.54
| Facility | | $11.22 | $30.90 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.62 / $7.76
| Professional | | $5.01 | $5.62 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $16.22 / $194.98
| Facility | | $9.33 | $16.22 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $10.47 / $15.85
| Professional | | $7.59 | $10.47 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $33.11 / $33.11
| Facility | | $10.23 | $33.11 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $22.39 / $54.95
| Facility | | $11.75 | $22.39 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $9.77 / $17.38
| Professional | | $5.75 | $9.77 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $74.13 / $74.13 / $74.13
| Facility | | $74.13 | $74.13 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $13.18 / $20.42
| Professional | | $8.51 | $13.18 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $52.48 / $251.19
| Facility | | $8.13 | $52.48 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $9.12 / $19.05
| Professional | | $6.03 | $9.12 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $8.51 / $8.51
| Professional | | $7.59 | $8.51 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $10.23 / $30.20
| Facility | | $8.13 | $10.23 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $9.55 / $17.38
| Professional | | $5.75 | $9.55 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $10.23 / $12.30
| Facility | | $4.57 | $10.23 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $6.03 / $14.13
| Professional | | $4.27 | $6.03 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.25 / $10.23
| Professional | | $3.98 | $5.25 | $10.23 |