- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $64.57 / $128.82
| Facility | | $22.39 | $64.57 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.02 / $85.11
| Professional | | $8.91 | $12.02 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $31.62 / $67.61
| Facility | | $6.46 | $31.62 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $10.47 / $38.02
| Professional | | $5.62 | $10.47 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $77.62 / $181.97
| Facility | | $29.51 | $77.62 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $12.88 / $38.90
| Professional | | $9.12 | $12.88 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $23.99 / $47.86
| Facility | | $9.77 | $23.99 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $14.79 / $28.84
| Professional | | $7.41 | $14.79 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.49 / $21.88
| Professional | | $10.96 | $13.49 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.49 / $30.90
| Professional | | $10.96 | $13.49 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $72.44 / $100.00
| Facility | | $72.44 | $72.44 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $16.22
| Professional | | $8.13 | $8.13 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $15.85 / $38.02
| Facility | | $10.96 | $15.85 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $11.48 / $28.84
| Professional | | $7.41 | $11.48 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $47.86 / $47.86
| Professional | | $47.86 | $47.86 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.80 / $22.91
| Professional | | $10.96 | $13.80 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $8.51 / $13.49
| Facility | | $6.17 | $8.51 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.92 / $25.70
| Professional | | $5.75 | $6.92 | $25.70 |