- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $61.66 / $138.04
| Facility | | $19.95 | $61.66 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.88 / $25.12
| Professional | | $10.23 | $12.88 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $20.42 / $72.44
| Facility | | $13.18 | $20.42 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $14.45 / $34.67
| Professional | | $7.08 | $14.45 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $35.48 / $56.23
| Facility | | $28.18 | $35.48 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $18.62
| Professional | | $13.49 | $13.49 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $22.91 / $54.95
| Facility | | $11.22 | $22.91 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $16.60 / $38.02
| Professional | | $8.71 | $16.60 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $93.33 / $7,079.46
| Facility | | $16.60 | $93.33 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $23.99
| Professional | | $20.42 | $20.42 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $14.45 / $38.90
| Professional | | $14.45 | $14.45 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $19.05 / $72.44
| Facility | | $16.60 | $19.05 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $20.42 / $72.44
| Facility | | $13.18 | $20.42 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $14.45 / $34.67
| Professional | | $7.08 | $14.45 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $14.79 / $21.38
| Professional | | $12.59 | $14.79 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $14.45 / $20.89
| Facility | | $7.24 | $14.45 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $12.02 / $38.90
| Professional | | $5.75 | $12.02 | $38.90 |