- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $36.31 / $64.57
| Facility | | $14.13 | $36.31 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $23.99
| Professional | | $7.94 | $10.00 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $93.33 / $5,011.87
| Facility | | $70.79 | $93.33 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $10.47 / $13.18
| Professional | | $10.47 | $10.47 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $20.42 / $45.71
| Facility | | $9.55 | $20.42 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $17.38 / $32.36
| Professional | | $7.76 | $17.38 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $9.55 / $19.50
| Professional | | $6.31 | $9.55 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $13.49
| Facility | | $13.49 | $13.49 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $14.79 / $23.44
| Professional | | $13.18 | $14.79 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $123.03 / $123.03 / $123.03
| Facility | | $123.03 | $123.03 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $35.48 / $45.71
| Facility | | $10.96 | $35.48 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $15.85
| Professional | | $7.94 | $10.00 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $19.95 / $69.18
| Facility | | $7.94 | $19.95 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $16.22 / $69.18
| Professional | | $7.94 | $16.22 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $13.49 / $15.85
| Facility | | $7.76 | $13.49 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $10.00 / $23.44
| Professional | | $6.03 | $10.00 | $23.44 |