- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $125.89 / $478.63
| Facility | | $22.39 | $125.89 | $478.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $20.89 / $33.11
| Professional | | $18.20 | $20.89 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $13.49 / $21.38
| Professional | | $8.51 | $13.49 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $6.03
| Facility | | $6.03 | $6.03 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $7.24
| Professional | | $7.24 | $7.24 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $70.79 / $158.49
| Facility | | $1.91 | $70.79 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $33.88 / $107.15
| Professional | | $12.30 | $33.88 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $21.88 / $44.67
| Facility | | $13.49 | $21.88 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.14 / $38.02
| Professional | | $10.00 | $15.14 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $11.75
| Facility | | $11.75 | $11.75 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $17.38 / $30.20
| Professional | | $11.75 | $17.38 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.45 / $165.96
| Facility | | $14.13 | $14.45 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $50,118.72 / $75,857.76
| Facility | | $9.77 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $147.91 / $416.87
| Facility | | $16.98 | $147.91 | $416.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $17.78 / $63.10
| Professional | | $10.23 | $17.78 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $14.13 / $33.11
| Facility | | $11.75 | $14.13 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $22.91 / $34.67
| Professional | | $11.75 | $22.91 | $34.67 |