- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $69.18 / $123.03
| Facility | | $20.89 | $69.18 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.59 / $39.81
| Professional | | $10.96 | $12.59 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $19.95 / $74.13
| Facility | | $12.88 | $19.95 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $14.13 / $34.67
| Professional | | $7.08 | $14.13 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $35.48 / $50.12
| Facility | | $28.18 | $35.48 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $14.45
| Professional | | $13.49 | $13.49 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $22.91 / $54.95
| Facility | | $11.22 | $22.91 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $16.60 / $37.15
| Professional | | $8.71 | $16.60 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $19.95 / $4,897.79
| Facility | | $14.13 | $19.95 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $18.62 / $23.99
| Professional | | $15.85 | $18.62 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $36.31
| Professional | | $14.13 | $14.13 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $21.38 / $114.82
| Facility | | $15.14 | $21.38 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $19.95 / $74.13
| Facility | | $12.88 | $19.95 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $14.13 / $34.67
| Professional | | $7.08 | $14.13 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $15.14 / $29.51
| Facility | | $11.75 | $15.14 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $12.59 / $21.38
| Professional | | $11.75 | $12.59 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $14.13 / $20.89
| Facility | | $7.08 | $14.13 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $11.48 / $45.71
| Professional | | $6.31 | $11.48 | $45.71 |