- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $147.91 / $288.40
| Facility | | $22.39 | $147.91 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $19.50 / $27.54
| Professional | | $10.96 | $19.50 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $40.74 / $41.69
| Facility | | $32.36 | $40.74 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $60.26
| Professional | | $7.41 | $7.41 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $12.02
| Facility | | $12.02 | $12.02 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $41.69 / $48.98 / $77.62
| Facility | | $41.69 | $48.98 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $21.38 / $46.77
| Professional | | $16.98 | $21.38 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $33.11 / $120.23
| Facility | | $13.49 | $33.11 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $15.14 / $141.25
| Facility | | $12.02 | $15.14 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.30 / $33.88
| Professional | | $8.91 | $12.30 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $33.11 / $85.11
| Professional | | $7.41 | $33.11 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $42.66
| Facility | | $18.20 | $18.20 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $24.55 / $42.66
| Professional | | $11.22 | $24.55 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $38.02 / $87.10
| Professional | | $19.95 | $38.02 | $87.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $141.25
| Facility | | $31.62 | $31.62 | $141.25 |
- 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
- $32.36 / $32.36 / $72.44
| Professional | | $32.36 | $32.36 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $72.44 / $81.28
| Professional | | $53.70 | $72.44 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $13.49 / $18.20
| Facility | | $7.59 | $13.49 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $12.02 / $33.88
| Professional | | $6.31 | $12.02 | $33.88 |