- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $67.61 / $186.21
| Facility | | $17.78 | $67.61 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $12.02 / $23.44
| Professional | | $7.94 | $12.02 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.13 / $13.18
| Professional | | $6.03 | $8.13 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $40.74 / $74.13
| Facility | | $14.45 | $40.74 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.24 / $10.00
| Professional | | $5.01 | $7.24 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $21.38 / $104.71
| Facility | | $12.02 | $21.38 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $13.18 / $19.95
| Professional | | $9.33 | $13.18 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $18.62 / $18.62
| Facility | | $13.18 | $18.62 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $28.84 / $67.61
| Facility | | $15.49 | $28.84 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $11.48 / $22.39
| Professional | | $7.59 | $11.48 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $85.11 / $85.11
| Facility | | $79.43 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $16.60 / $23.44
| Professional | | $11.22 | $16.60 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $29.51 / $138.04
| Facility | | $10.47 | $29.51 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $12.02 / $21.88
| Professional | | $7.41 | $12.02 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $11.22 / $11.22
| Professional | | $10.00 | $11.22 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $13.18 / $39.81
| Facility | | $10.47 | $13.18 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $10.96 / $21.88
| Professional | | $7.59 | $10.96 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $13.18 / $15.85
| Facility | | $5.62 | $13.18 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $7.59 / $13.18
| Professional | | $5.62 | $7.59 | $13.18 |