- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $52.48 / $144.54
| Facility | | $19.50 | $52.48 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $251.19
| Professional | | $7.94 | $10.96 | $251.19 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $70.79 / $151.36
| Facility | | $5.62 | $70.79 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.13 / $27.54
| Professional | | $4.79 | $5.13 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $61.66 / $138.04
| Facility | | $22.91 | $61.66 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $14.13 / $40.74
| Professional | | $10.96 | $14.13 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $43.65 / $109.65
| Facility | | $8.51 | $43.65 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $45.71 / $67.61
| Professional | | $17.38 | $45.71 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $38.02 / $60.26
| Professional | | $12.02 | $38.02 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $38.02 / $87.10
| Professional | | $30.20 | $38.02 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $177.83 / $177.83
| Facility | | $177.83 | $177.83 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $30.90 / $85.11
| Facility | | $10.47 | $30.90 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $28.84 / $79.43
| Professional | | $6.76 | $28.84 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $16.98 / $38.02
| Professional | | $12.02 | $16.98 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $25.70 / $38.02
| Facility | | $16.98 | $25.70 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.24 / $42.66
| Professional | | $5.01 | $7.24 | $42.66 |