- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $61.66 / $134.90
| Facility | | $16.22 | $61.66 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $45.71
| Professional | | $7.94 | $10.96 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $8.13
| Professional | | $7.24 | $7.24 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $27.54 / $58.88
| Facility | | $6.76 | $27.54 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $10.47 / $39.81
| Professional | | $5.89 | $10.47 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $81.28 / $186.21
| Facility | | $26.92 | $81.28 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $13.49 / $38.90
| Professional | | $9.33 | $13.49 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $20.89 / $43.65
| Facility | | $8.91 | $20.89 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $13.49 / $30.20
| Professional | | $6.92 | $13.49 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $11.75 / $19.05
| Professional | | $10.47 | $11.75 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $11.75 / $26.92
| Professional | | $9.55 | $11.75 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $70.79 / $72.44
| Facility | | $70.79 | $70.79 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $14.13
| Professional | | $7.08 | $7.08 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $14.13 / $35.48
| Facility | | $9.77 | $14.13 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $10.96 / $30.20
| Professional | | $6.92 | $10.96 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $41.69 / $41.69
| Professional | | $41.69 | $41.69 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $12.02 / $19.95
| Professional | | $9.55 | $12.02 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $8.13 / $11.75
| Facility | | $5.37 | $8.13 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.08 / $23.99
| Professional | | $5.01 | $7.08 | $23.99 |