- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $46.77 / $123.03
| Facility | | $15.85 | $46.77 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $12.88 / $75.86
| Professional | | $7.94 | $12.88 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.92 / $7.08
| Professional | | $5.75 | $6.92 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $26.92 / $57.54
| Facility | | $6.61 | $26.92 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $10.00 / $38.90
| Professional | | $5.62 | $10.00 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $79.43 / $181.97
| Facility | | $26.30 | $79.43 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $13.18 / $37.15
| Professional | | $9.12 | $13.18 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $20.42 / $41.69
| Facility | | $8.71 | $20.42 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $11.48 / $28.84
| Professional | | $6.76 | $11.48 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $11.48 / $18.20
| Professional | | $10.23 | $11.48 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $11.48 / $25.70
| Professional | | $9.12 | $11.48 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $69.18 / $69.18 / $69.18
| Facility | | $69.18 | $69.18 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $13.80
| Professional | | $6.92 | $6.92 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $13.80 / $34.67
| Facility | | $9.55 | $13.80 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $10.47 / $28.84
| Professional | | $6.76 | $10.47 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $39.81 / $39.81
| Professional | | $39.81 | $39.81 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $11.75 / $19.50
| Professional | | $9.12 | $11.75 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $7.94 / $11.48
| Facility | | $5.13 | $7.94 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $6.92 / $23.99
| Professional | | $4.79 | $6.92 | $23.99 |