- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $48.98 / $125.89
| Facility | | $17.38 | $48.98 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $32.36
| Professional | | $8.91 | $10.96 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $16.98 / $60.26
| Facility | | $10.96 | $16.98 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $12.02 / $29.51
| Professional | | $7.24 | $12.02 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $29.51 / $46.77
| Facility | | $23.44 | $29.51 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $15.49
| Professional | | $11.22 | $11.22 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $19.05 / $46.77
| Facility | | $9.33 | $19.05 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $13.49 / $31.62
| Professional | | $7.41 | $13.49 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $120.23 / $7,079.46
| Facility | | $13.80 | $120.23 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $20.42
| Professional | | $17.38 | $17.38 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $33.11
| Professional | | $12.02 | $12.02 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $16.60 / $95.50
| Facility | | $14.13 | $16.60 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $16.98 / $60.26
| Facility | | $10.96 | $16.98 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $12.02 / $29.51
| Professional | | $7.24 | $12.02 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $15.14 / $30.20
| Facility | | $10.72 | $15.14 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $12.30 / $18.20
| Professional | | $10.72 | $12.30 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $12.02 / $17.78
| Facility | | $6.03 | $12.02 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $10.00 / $38.90
| Professional | | $7.24 | $10.00 | $38.90 |