- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $37.15 / $79.43
| Facility | | $6.03 | $37.15 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $20.89 / $66.07
| Professional | | $6.03 | $20.89 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $30.20 / $128.82
| Facility | | $19.95 | $30.20 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $23.99 / $66.07
| Professional | | $5.89 | $23.99 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $42.66 / $53.70 / $77.62
| Facility | | $42.66 | $53.70 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $25.70 / $25.70
| Professional | | $8.91 | $25.70 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $18.20 / $43.65
| Facility | | $8.13 | $18.20 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $29.51 / $70.79
| Professional | | $6.61 | $29.51 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $45.71 / $7,079.46
| Facility | | $6.46 | $45.71 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $38.90 / $38.90 / $45.71
| Professional | | $38.90 | $38.90 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $26.92 / $57.54
| Professional | | $26.92 | $26.92 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $30.20 / $128.82
| Facility | | $19.95 | $30.20 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $23.99 / $66.07
| Professional | | $5.89 | $23.99 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $14.45 / $26.92
| Facility | | $5.89 | $14.45 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $16.22 / $51.29
| Professional | | $5.25 | $16.22 | $51.29 |