- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $69.18 / $147.91
| Facility | | $22.91 | $69.18 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.14 / $100.00
| Professional | | $10.00 | $15.14 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $37.15 / $79.43
| Facility | | $7.59 | $37.15 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $11.75 / $37.15
| Professional | | $6.46 | $11.75 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $87.10 / $208.93
| Facility | | $34.67 | $87.10 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $15.14 / $45.71
| Professional | | $10.47 | $15.14 | $45.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $28.18 / $54.95
| Facility | | $11.48 | $28.18 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $16.98 / $33.11
| Professional | | $8.51 | $16.98 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.85 / $25.70
| Professional | | $12.88 | $15.85 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.85 / $37.15
| Professional | | $12.88 | $15.85 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Facility | | $75.86 | $75.86 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $15.85
| Professional | | $7.94 | $7.94 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $18.62 / $42.66
| Facility | | $11.75 | $18.62 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $13.18 / $33.11
| Professional | | $8.51 | $13.18 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $56.23 / $56.23 / $56.23
| Professional | | $56.23 | $56.23 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $16.22 / $26.92
| Professional | | $12.88 | $16.22 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $9.77 / $15.85
| Facility | | $7.24 | $9.77 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $7.94 / $30.20
| Professional | | $6.76 | $7.94 | $30.20 |