- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $208.93 / $794.33
| Facility | | $24.55 | $208.93 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $12.02 / $70.79
| Professional | | $7.94 | $12.02 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.92 / $16.60
| Professional | | $5.13 | $6.92 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $23.99 / $51.29
| Facility | | $5.89 | $23.99 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $9.12 / $28.84
| Professional | | $5.13 | $9.12 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $74.13 / $165.96
| Facility | | $23.99 | $74.13 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $11.75 / $33.88
| Professional | | $8.32 | $11.75 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $18.20 / $38.02
| Facility | | $7.76 | $18.20 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $12.02 / $25.70
| Professional | | $6.17 | $12.02 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.23 / $16.60
| Professional | | $8.91 | $10.23 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.23 / $23.99
| Professional | | $8.32 | $10.23 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $112.20 / $112.20
| Facility | | $112.20 | $112.20 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $42.66 / $57.54
| Professional | | $14.13 | $42.66 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $12.30
| Professional | | $6.17 | $6.17 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $12.30 / $30.90
| Facility | | $8.71 | $12.30 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $9.55 / $25.70
| Professional | | $6.17 | $9.55 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $36.31
| Professional | | $36.31 | $36.31 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.47 / $17.38
| Professional | | $8.32 | $10.47 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $7.08 / $10.23
| Facility | | $4.37 | $7.08 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.17 / $38.02
| Professional | | $4.37 | $6.17 | $38.02 |