- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $36.31 / $204.17
| Facility | | $8.91 | $36.31 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.72 / $14.45
| Professional | | $7.08 | $10.72 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $8.32 / $8.32
| Professional | | $5.75 | $8.32 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $38.90 / $70.79
| Facility | | $13.18 | $38.90 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.61 / $12.02
| Professional | | $5.01 | $6.61 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $18.62 / $87.10
| Facility | | $10.96 | $18.62 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $12.30 / $19.05
| Professional | | $8.32 | $12.30 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $12.02
| Facility | | $11.75 | $11.75 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $26.30 / $64.57
| Facility | | $14.13 | $26.30 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $8.91 / $20.42
| Professional | | $6.76 | $8.91 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $72.44 / $72.44
| Facility | | $72.44 | $72.44 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $23.99 / $23.99
| Professional | | $23.99 | $23.99 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.02 / $104.71
| Facility | | $8.91 | $12.02 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.72 / $20.89
| Professional | | $7.08 | $10.72 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.00 / $10.00
| Professional | | $8.91 | $10.00 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,454.71 / $3,311.31 / $4,265.80
| Facility | | $2,454.71 | $3,311.31 | $4,265.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $12.02 / $35.48
| Facility | | $9.55 | $12.02 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $8.91 / $19.95
| Professional | | $6.76 | $8.91 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $12.02 / $14.45
| Facility | | $5.37 | $12.02 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.08 / $14.13
| Professional | | $5.01 | $7.08 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.17 / $12.02
| Professional | | $4.68 | $6.17 | $12.02 |