- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $53.70 / $109.65
| Facility | | $20.89 | $53.70 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.88 / $69.18
| Professional | | $10.00 | $12.88 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $38.02 / $83.18
| Facility | | $7.59 | $38.02 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $11.75 / $30.20
| Professional | | $6.61 | $11.75 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $66.07 / $147.91
| Facility | | $24.55 | $66.07 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.47 / $35.48
| Professional | | $7.41 | $10.47 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $28.84 / $56.23
| Facility | | $11.48 | $28.84 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $14.79 / $32.36
| Professional | | $8.71 | $14.79 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $16.60 / $26.30
| Professional | | $10.00 | $16.60 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $16.60 / $36.31
| Professional | | $13.18 | $16.60 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $77.62 / $77.62
| Facility | | $77.62 | $77.62 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $16.60
| Professional | | $8.13 | $8.13 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $17.38 / $42.66
| Facility | | $11.75 | $17.38 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $12.59 / $33.11
| Professional | | $8.71 | $12.59 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $57.54 / $57.54
| Professional | | $57.54 | $57.54 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $13.18 / $16.98
| Professional | | $10.00 | $13.18 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.77 / $16.60
| Facility | | $7.41 | $9.77 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $9.77 / $30.90
| Professional | | $6.92 | $9.77 | $30.90 |