- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $75.86 / $181.97
| Facility | | $26.30 | $75.86 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $16.22 / $19.95
| Professional | | $12.88 | $16.22 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $25.12 / $93.33
| Facility | | $16.22 | $25.12 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $17.78 / $43.65
| Professional | | $10.72 | $17.78 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $44.67 / $70.79
| Facility | | $35.48 | $44.67 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $22.91
| Professional | | $16.98 | $16.98 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $28.84 / $69.18
| Facility | | $14.13 | $28.84 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $20.42 / $46.77
| Professional | | $10.96 | $20.42 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $144.54 / $7,079.46
| Facility | | $20.42 | $144.54 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $26.30 / $30.90
| Professional | | $26.30 | $26.30 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $48.98
| Professional | | $17.78 | $17.78 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $38.90 / $93.33
| Facility | | $21.38 | $38.90 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $25.12 / $93.33
| Facility | | $16.22 | $25.12 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $17.78 / $43.65
| Professional | | $10.72 | $17.78 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $20.42 / $29.51
| Facility | | $15.85 | $20.42 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $18.20 / $26.92
| Professional | | $15.85 | $18.20 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $17.78 / $26.30
| Facility | | $8.91 | $17.78 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $15.14 / $48.98
| Professional | | $10.72 | $15.14 | $48.98 |