- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $33.11 / $117.49
| Facility | | $14.13 | $33.11 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $22.91
| Professional | | $7.94 | $10.00 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $85.11 / $5,011.87
| Facility | | $64.57 | $85.11 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $11.48
| Professional | | $9.33 | $9.33 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $18.62 / $41.69
| Facility | | $8.71 | $18.62 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $15.49 / $29.51
| Professional | | $7.08 | $15.49 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $8.13 / $17.38
| Professional | | $5.75 | $8.13 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $12.02
| Facility | | $12.02 | $12.02 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $13.49 / $20.89
| Professional | | $12.02 | $13.49 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $34.67 / $134.90
| Facility | | $18.20 | $34.67 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $9.12 / $11.48
| Professional | | $7.24 | $9.12 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $30.90 / $41.69
| Facility | | $10.00 | $30.90 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $18.62
| Professional | | $7.94 | $10.00 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $19.05 / $19.05
| Facility | | $12.02 | $19.05 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $16.98 / $70.79
| Professional | | $10.72 | $16.98 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $12.02 / $14.45
| Facility | | $7.08 | $12.02 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $7.94 / $20.89
| Professional | | $5.25 | $7.94 | $20.89 |