- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $81.28 / $165.96
| Facility | | $28.84 | $81.28 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $14.13 / $97.72
| Professional | | $10.96 | $14.13 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $34.67 / $74.13
| Facility | | $8.51 | $34.67 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $12.88 / $41.69
| Professional | | $7.24 | $12.88 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $91.20 / $234.42
| Facility | | $33.88 | $91.20 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $16.60 / $47.86
| Professional | | $11.75 | $16.60 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $25.70 / $53.70
| Facility | | $11.22 | $25.70 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $16.98 / $37.15
| Professional | | $8.71 | $16.98 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $14.79 / $23.44
| Professional | | $13.18 | $14.79 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $14.79 / $33.11
| Professional | | $11.75 | $14.79 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $85.11 / $85.11
| Facility | | $70.79 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $17.78
| Professional | | $8.91 | $8.91 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $17.78 / $42.66
| Facility | | $12.30 | $17.78 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $13.49 / $37.15
| Professional | | $8.71 | $13.49 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $51.29 / $51.29 / $51.29
| Professional | | $51.29 | $51.29 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $15.14 / $25.12
| Professional | | $11.75 | $15.14 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $10.00 / $14.79
| Facility | | $6.61 | $10.00 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $8.91 / $30.90
| Professional | | $6.17 | $8.91 | $30.90 |