- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $21.88 / $54.95
| Facility | | $7.94 | $21.88 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $17.78
| Professional | | $6.03 | $7.08 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.96 / $112.20
| Facility | | $7.08 | $10.96 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $7.76 / $18.62
| Professional | | $4.68 | $7.76 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $18.62 / $26.92
| Facility | | $14.79 | $18.62 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $11.22
| Professional | | $7.24 | $7.24 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $13.18 / $33.88
| Facility | | $6.03 | $13.18 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $9.33 / $19.95
| Professional | | $4.79 | $9.33 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $69.18 / $7,079.46
| Facility | | $10.23 | $69.18 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $13.18
| Professional | | $11.22 | $11.22 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $20.89
| Professional | | $7.76 | $7.76 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.96 / $112.20
| Facility | | $7.08 | $10.96 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $7.76 / $18.62
| Professional | | $4.68 | $7.76 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $7.76 / $12.88
| Facility | | $3.89 | $7.76 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $7.76 / $20.89
| Professional | | $4.68 | $7.76 | $20.89 |