- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $42.66 / $131.83
| Facility | | $15.14 | $42.66 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.72 / $218.78
| Professional | | $8.91 | $10.72 | $218.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $16.98 / $134.90
| Facility | | $10.96 | $16.98 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $12.02 / $29.51
| Professional | | $6.31 | $12.02 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $38.02 / $54.95
| Facility | | $30.20 | $38.02 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $11.22
| Professional | | $11.22 | $11.22 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $19.05 / $46.77
| Facility | | $9.33 | $19.05 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $20.89 / $51.29
| Professional | | $16.60 | $20.89 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $19.05 / $1,995.26
| Facility | | $12.02 | $19.05 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $19.95 / $30.20
| Professional | | $13.80 | $19.95 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $28.18
| Professional | | $12.02 | $12.02 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $25.70 / $323.59
| Facility | | $11.22 | $25.70 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $16.98 / $134.90
| Facility | | $10.96 | $16.98 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $12.02 / $29.51
| Professional | | $6.31 | $12.02 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.72 / $18.20
| Professional | | $8.91 | $10.72 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $12.02 / $19.50
| Facility | | $6.03 | $12.02 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $9.55 / $32.36
| Professional | | $6.31 | $9.55 | $32.36 |