- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $51.29 / $141.25
| Facility | | $14.79 | $51.29 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.88 / $91.20
| Professional | | $10.00 | $12.88 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $8.51
| Professional | | $8.32 | $8.32 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $32.36 / $69.18
| Facility | | $7.08 | $32.36 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $10.96 / $41.69
| Professional | | $6.17 | $10.96 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $85.11 / $199.53
| Facility | | $30.90 | $85.11 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $14.13 / $40.74
| Professional | | $10.00 | $14.13 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $24.55 / $50.12
| Facility | | $10.47 | $24.55 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $15.14 / $30.90
| Professional | | $7.41 | $15.14 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $13.80 / $21.88
| Professional | | $11.22 | $13.80 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.80 / $33.11
| Professional | | $10.96 | $13.80 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $151.36 / $151.36
| Facility | | $66.07 | $151.36 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $16.60
| Professional | | $8.32 | $8.32 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $16.22 / $40.74
| Facility | | $10.96 | $16.22 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $12.30 / $30.90
| Professional | | $7.41 | $12.30 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $47.86 / $47.86
| Professional | | $47.86 | $47.86 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $14.13 / $23.44
| Professional | | $10.96 | $14.13 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $9.33 / $13.80
| Facility | | $6.17 | $9.33 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.59 / $26.30
| Professional | | $5.75 | $7.59 | $26.30 |