- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $52.48 / $251.19
| Facility | | $12.02 | $52.48 | $251.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $15.14 / $42.66
| Professional | | $8.91 | $15.14 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $7.76
| Professional | | $7.76 | $7.76 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $51.29 / $89.13
| Facility | | $18.20 | $51.29 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $8.91 / $14.79
| Professional | | $5.01 | $8.91 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $16.22 / $25.70
| Professional | | $11.22 | $16.22 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $31.62 / $31.62
| Facility | | $16.22 | $31.62 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $33.88 / $74.13
| Facility | | $18.20 | $33.88 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $12.30 / $27.54
| Professional | | $9.12 | $12.30 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $199.53 / $199.53 / $199.53
| Facility | | $199.53 | $199.53 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $32.36
| Professional | | $32.36 | $32.36 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $16.22 / $87.10
| Facility | | $12.02 | $16.22 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $14.45 / $30.90
| Professional | | $8.91 | $14.45 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $13.49 / $13.49
| Professional | | $12.02 | $13.49 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $16.22 / $46.77
| Facility | | $12.30 | $16.22 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $11.75 / $26.92
| Professional | | $9.12 | $11.75 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $16.22 / $19.50
| Facility | | $7.24 | $16.22 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $9.33 / $13.80
| Professional | | $6.76 | $9.33 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $8.32 / $16.22
| Professional | | $6.31 | $8.32 | $16.22 |