- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $69.18 / $269.15
| Facility | | $17.38 | $69.18 | $269.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $9.33 / $67.61
| Professional | | $7.08 | $9.33 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $6.31 / $10.23
| Professional | | $6.31 | $6.31 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $45.71 / $1,584.89
| Facility | | $16.22 | $45.71 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $72.44 / $5,011.87
| Facility | | $54.95 | $72.44 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $9.77
| Professional | | $8.13 | $8.13 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $15.85 / $35.48
| Facility | | $7.41 | $15.85 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $13.49 / $25.12
| Professional | | $6.03 | $13.49 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $8.32 / $14.79
| Professional | | $4.79 | $8.32 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $10.23
| Facility | | $10.23 | $10.23 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $11.48 / $17.78
| Professional | | $10.23 | $11.48 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $32.36 / $109.65
| Facility | | $14.45 | $32.36 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.92 / $8.91
| Professional | | $6.17 | $6.92 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $44.67 / $912.01
| Facility | | $11.75 | $44.67 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $21.88 / $54.95
| Facility | | $7.24 | $21.88 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $18.20
| Professional | | $7.08 | $8.91 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,000.00 / $1,148.15 / $1,445.44
| Facility | | $1,000.00 | $1,148.15 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $12.02 / $15.49
| Facility | | $5.62 | $12.02 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $12.02 / $15.49
| Professional | | $5.62 | $12.02 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $10.23 / $12.30
| Facility | | $5.62 | $10.23 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $7.76 / $17.78
| Professional | | $4.68 | $7.76 | $17.78 |