- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $47.86 / $85.11
| Facility | | $15.14 | $47.86 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.85 / $32.36
| Professional | | $10.00 | $15.85 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $10.72
| Professional | | $10.72 | $10.72 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $79.43 / $1,202.26
| Facility | | $25.12 | $79.43 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $123.03 / $5,011.87
| Facility | | $91.20 | $123.03 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $17.38
| Professional | | $14.13 | $14.13 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $27.54 / $61.66
| Facility | | $12.88 | $27.54 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $25.12 / $46.77
| Professional | | $10.47 | $25.12 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.72 / $26.30
| Professional | | $8.51 | $10.72 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $17.78
| Facility | | $17.78 | $17.78 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $19.05 / $30.90
| Professional | | $15.14 | $19.05 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $40.74 / $95.50
| Facility | | $15.85 | $40.74 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $12.02 / $13.49
| Professional | | $10.72 | $12.02 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $66.07 / $154.88
| Facility | | $20.89 | $66.07 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $26.92 / $57.54
| Facility | | $12.59 | $26.92 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $14.13 / $20.89
| Professional | | $10.00 | $14.13 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $17.78 / $26.30
| Facility | | $13.49 | $17.78 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $17.78 / $26.30
| Professional | | $13.49 | $17.78 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $17.78 / $21.38
| Facility | | $10.72 | $17.78 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $11.75 / $30.20
| Professional | | $7.59 | $11.75 | $30.20 |