- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $32.36 / $199.53
| Facility | | $14.13 | $32.36 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $20.42
| Professional | | $7.94 | $10.96 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $16.22 / $70.79
| Facility | | $10.47 | $16.22 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $14.13 / $34.67
| Professional | | $5.89 | $14.13 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $28.18 / $39.81
| Facility | | $22.39 | $28.18 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $13.18 / $13.18
| Professional | | $11.22 | $13.18 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $18.20 / $39.81
| Facility | | $9.55 | $18.20 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $16.60 / $37.15
| Professional | | $7.94 | $16.60 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $57.54 / $7,079.46
| Facility | | $10.00 | $57.54 | $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
- $14.13 / $14.13 / $30.20
| Professional | | $14.13 | $14.13 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $21.88 / $35.48
| Facility | | $21.88 | $21.88 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $16.22 / $70.79
| Facility | | $10.47 | $16.22 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $14.13 / $34.67
| Professional | | $5.89 | $14.13 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $13.18 / $16.98
| Facility | | $6.31 | $13.18 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $10.72 / $34.67
| Professional | | $5.25 | $10.72 | $34.67 |