- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $63.10 / $131.83
| Facility | | $18.62 | $63.10 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.80 / $85.11
| Professional | | $10.96 | $13.80 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $15.14
| Professional | | $9.12 | $9.12 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $63.10 / $131.83
| Facility | | $23.44 | $63.10 | $131.83 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $107.15 / $5,011.87
| Facility | | $81.28 | $107.15 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $15.14
| Professional | | $12.02 | $12.02 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $23.44 / $52.48
| Facility | | $10.96 | $23.44 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $19.50 / $37.15
| Professional | | $8.91 | $19.50 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $15.14 / $22.39
| Professional | | $7.24 | $15.14 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $15.14
| Facility | | $15.14 | $15.14 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $16.98 / $26.30
| Professional | | $15.14 | $16.98 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $38.90 / $93.33
| Facility | | $22.39 | $38.90 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $12.59
| Professional | | $9.12 | $9.12 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $60.26 / $134.90
| Facility | | $17.38 | $60.26 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $28.18 / $81.28
| Facility | | $10.72 | $28.18 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.88 / $23.99
| Professional | | $10.00 | $12.88 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $169.82 / $933.25
| Facility | | $165.96 | $169.82 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $15.14 / $47.86
| Facility | | $13.80 | $15.14 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $16.22 / $47.86
| Professional | | $13.80 | $16.22 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $15.14 / $18.20
| Facility | | $8.91 | $15.14 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $10.23 / $26.30
| Professional | | $6.46 | $10.23 | $26.30 |