- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $53.70 / $89.13
| Facility | | $21.88 | $53.70 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $15.85 / $134.90
| Professional | | $8.91 | $15.85 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $47.86 / $63.10 / $5,011.87
| Facility | | $47.86 | $63.10 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $15.85 / $15.85
| Professional | | $15.85 | $15.85 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $27.54 / $60.26
| Facility | | $13.49 | $27.54 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $17.78 / $30.20
| Professional | | $5.50 | $17.78 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $11.48 / $29.51
| Professional | | $9.55 | $11.48 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $20.42
| Facility | | $20.42 | $20.42 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $14.45 / $35.48
| Professional | | $9.33 | $14.45 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $50.12 / $61.66
| Facility | | $16.98 | $50.12 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $13.49
| Professional | | $13.49 | $13.49 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $23.44 / $69.18
| Facility | | $16.60 | $23.44 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $15.85 / $23.99
| Professional | | $8.91 | $15.85 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $20.42
| Facility | | $10.72 | $10.72 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $10.72 / $20.42
| Professional | | $10.47 | $10.72 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $20.42 / $24.55
| Facility | | $6.17 | $20.42 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $12.30 / $25.70
| Professional | | $6.31 | $12.30 | $25.70 |