- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $102.33 / $213.80
| Facility | | $52.48 | $102.33 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $9.33 / $97.72
| Professional | | $7.94 | $9.33 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $27.54 / $28.18
| Facility | | $21.88 | $27.54 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $40.74
| Professional | | $5.01 | $5.01 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $10.72
| Facility | | $6.92 | $6.92 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $10.23
| Professional | | $10.23 | $10.23 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $32.36 / $52.48
| Facility | | $28.18 | $32.36 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $14.45 / $31.62
| Professional | | $11.48 | $14.45 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $22.39 / $64.57
| Facility | | $9.12 | $22.39 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $138.04 / $204.17
| Facility | | $12.30 | $138.04 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.76 / $33.11
| Professional | | $5.13 | $6.76 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $28.18 / $64.57
| Professional | | $10.23 | $28.18 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $22.91
| Facility | | $12.30 | $12.30 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $15.85 / $28.84
| Professional | | $7.59 | $15.85 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $25.70 / $56.23
| Professional | | $13.18 | $25.70 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $74.13
| Facility | | $20.42 | $20.42 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $6.76 / $10.00
| Professional | | $5.37 | $6.76 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $21.88
| Professional | | $17.38 | $17.38 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $34.67 / $56.23
| Professional | | $17.38 | $34.67 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $9.12 / $12.30
| Facility | | $5.13 | $9.12 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $8.13 / $28.18
| Professional | | $4.79 | $8.13 | $28.18 |