- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $45.71 / $398.11
| Facility | | $7.76 | $45.71 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.94 / $12.02
| Professional | | $6.03 | $7.94 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $6.31 / $6.31
| Professional | | $6.31 | $6.31 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $34.67 / $60.26
| Facility | | $13.18 | $34.67 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.62 / $10.00
| Professional | | $5.01 | $5.62 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $13.80 / $102.33
| Facility | | $9.12 | $13.80 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $10.72
| Facility | | $10.23 | $10.23 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $21.38 / $47.86
| Facility | | $11.48 | $21.38 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.41 / $16.98
| Professional | | $5.75 | $7.41 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $141.25 / $141.25
| Facility | | $79.43 | $141.25 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $20.42
| Professional | | $20.42 | $20.42 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.23 / $114.82
| Facility | | $7.41 | $10.23 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $9.33 / $16.60
| Professional | | $6.03 | $9.33 | $16.60 |
- 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
- $7.41 / $10.23 / $30.20
| Facility | | $7.41 | $10.23 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.41 / $16.98
| Professional | | $5.75 | $7.41 | $16.98 |
- 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 / $5.89 / $10.00
| Professional | | $4.27 | $5.89 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.25 / $10.23
| Professional | | $3.98 | $5.25 | $10.23 |