- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $83.18 / $263.03
| Facility | | $25.70 | $83.18 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.24 / $51.29
| Professional | | $6.03 | $7.24 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $21.88 / $22.39
| Facility | | $17.38 | $21.88 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $32.36
| Professional | | $6.03 | $6.03 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $8.51
| Facility | | $6.17 | $6.17 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $8.13
| Professional | | $8.13 | $8.13 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $26.30 / $41.69
| Facility | | $22.39 | $26.30 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $11.75 / $25.12
| Professional | | $9.55 | $11.75 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $17.78 / $64.57
| Facility | | $7.24 | $17.78 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $69.18 / $107.15
| Facility | | $8.13 | $69.18 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.76 / $19.95
| Professional | | $4.68 | $6.76 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $28.84 / $64.57
| Professional | | $8.13 | $28.84 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $22.91
| Facility | | $9.77 | $9.77 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $13.18 / $22.91
| Professional | | $6.03 | $13.18 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $20.42 / $40.74
| Professional | | $10.72 | $20.42 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $60.26
| Facility | | $17.38 | $17.38 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.37 / $7.76
| Professional | | $4.27 | $5.37 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $18.20
| Professional | | $17.38 | $17.38 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $43.65
| Professional | | $18.20 | $18.20 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $7.24 / $9.77
| Facility | | $4.07 | $7.24 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $6.61 / $22.39
| Professional | | $4.07 | $6.61 | $22.39 |