- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $46.77 / $83.18
| Facility | | $12.88 | $46.77 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.02 / $30.20
| Professional | | $10.00 | $12.02 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $9.55 / $9.55
| Professional | | $9.55 | $9.55 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $112.20 / $5,011.87
| Facility | | $83.18 | $112.20 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $13.80
| Professional | | $12.30 | $12.30 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $23.99 / $53.70
| Facility | | $11.48 | $23.99 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $20.42 / $38.02
| Professional | | $9.33 | $20.42 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $15.85 / $22.91
| Professional | | $7.41 | $15.85 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $15.85 / $15.85
| Facility | | $15.85 | $15.85 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $17.78 / $27.54
| Professional | | $15.85 | $17.78 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $51.29 / $141.25
| Facility | | $21.38 | $51.29 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $10.72 / $13.49
| Professional | | $9.55 | $10.72 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $23.99 / $46.77
| Facility | | $10.96 | $23.99 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.88 / $19.05
| Professional | | $10.96 | $12.88 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $20.42 / $21.88
| Facility | | $7.08 | $20.42 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $20.42 / $21.88
| Professional | | $7.08 | $20.42 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $15.85 / $19.05
| Facility | | $9.33 | $15.85 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $10.47 / $27.54
| Professional | | $6.61 | $10.47 | $27.54 |