- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $37.15 / $138.04
| Facility | | $10.72 | $37.15 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $14.79
| Professional | | $7.94 | $10.00 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $7.76 / $7.76
| Professional | | $3.09 | $7.76 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $34.67 / $41.69
| Facility | | $25.12 | $34.67 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $10.23 / $12.59
| Professional | | $6.76 | $10.23 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $23.44 / $51.29
| Facility | | $7.76 | $23.44 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $7.94 / $17.38
| Professional | | $5.89 | $7.94 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $24.55 / $33.88
| Professional | | $9.33 | $24.55 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.23 / $21.88
| Facility | | $8.91 | $10.23 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $12.02 / $13.18
| Professional | | $9.12 | $12.02 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $676.08 / $676.08 / $1,258.93
| Facility | | $676.08 | $676.08 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $11.22 / $19.50
| Facility | | $5.89 | $11.22 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $7.94 / $15.85
| Professional | | $5.62 | $7.94 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $60.26
| Facility | | $60.26 | $60.26 | $60.26 |