- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $120.23 / $245.47
| Facility | | $45.71 | $120.23 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $9.55 / $35.48
| Professional | | $7.94 | $9.55 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $28.84 / $29.51
| Facility | | $22.91 | $28.84 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $42.66
| Professional | | $5.25 | $5.25 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $11.22
| Facility | | $8.71 | $8.71 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $10.72
| Professional | | $10.72 | $10.72 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $34.67 / $54.95
| Facility | | $29.51 | $34.67 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $15.49 / $33.88
| Professional | | $12.30 | $15.49 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $23.44 / $85.11
| Facility | | $9.55 | $23.44 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $47.86 / $134.90
| Facility | | $9.55 | $47.86 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $8.91 / $24.55
| Professional | | $6.46 | $8.91 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $20.89 / $64.57
| Professional | | $5.37 | $20.89 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $12.88 / $30.90
| Facility | | $12.88 | $12.88 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $17.78 / $30.20
| Professional | | $8.13 | $17.78 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $26.92 / $48.98
| Professional | | $14.13 | $26.92 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $22.91 / $60.26
| Facility | | $22.91 | $22.91 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.08 / $10.47
| Professional | | $5.75 | $7.08 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $22.91 / $27.54
| Professional | | $22.91 | $22.91 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $30.90 / $58.88
| Professional | | $27.54 | $30.90 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $9.55 / $12.88
| Facility | | $5.37 | $9.55 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $8.51 / $26.30
| Professional | | $5.37 | $8.51 | $26.30 |