- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $33.11 / $234.42
| Facility | | $14.13 | $33.11 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $14.13 / $32.36
| Professional | | $8.91 | $14.13 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $32.36 / $33.11
| Facility | | $25.70 | $32.36 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $5.89 / $42.66
| Professional | | $5.89 | $5.89 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $9.55 / $9.55
| Facility | | $9.55 | $9.55 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $38.90 / $61.66
| Facility | | $33.11 | $38.90 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $16.98 / $37.15
| Professional | | $13.49 | $16.98 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $26.30 / $46.77
| Facility | | $10.72 | $26.30 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $11.22 / $77.62
| Facility | | $9.55 | $11.22 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $7.24 / $18.62
| Professional | | $4.79 | $7.24 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $32.36 / $85.11
| Professional | | $7.94 | $32.36 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $14.45 / $18.62
| Facility | | $12.88 | $14.45 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.30 / $33.88
| Professional | | $8.91 | $12.30 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $30.90 / $60.26
| Professional | | $15.85 | $30.90 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $77.62
| Facility | | $25.70 | $25.70 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $7.76 / $11.75
| Professional | | $6.31 | $7.76 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $128.82
| Professional | | $25.70 | $25.70 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $128.82 / $128.82
| Professional | | $34.67 | $128.82 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $10.72 / $14.45
| Facility | | $6.03 | $10.72 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $7.24 / $19.95
| Professional | | $4.79 | $7.24 | $19.95 |