- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $104.71
| Facility | | $3.02 | $3.02 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $8.51 / $64.57
| Professional | | $3.02 | $8.51 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $15.49
| Professional | | $15.49 | $15.49 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $18.62 / $46.77
| Facility | | $14.79 | $18.62 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $22.91 / $52.48
| Professional | | $9.33 | $22.91 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $39.81 / $63.10 / $199.53
| Facility | | $39.81 | $63.10 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $27.54 / $51.29
| Professional | | $20.42 | $27.54 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $20.42 / $40.74
| Professional | | $8.91 | $20.42 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $21.88 / $53.70
| Professional | | $16.60 | $21.88 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $104.71 / $104.71
| Facility | | $104.71 | $104.71 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $23.44 / $23.44
| Professional | | $23.44 | $23.44 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $16.98 / $30.20
| Facility | | $4.27 | $16.98 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $19.50 / $43.65
| Professional | | $8.91 | $19.50 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $46.77 / $46.77
| Professional | | $46.77 | $46.77 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $138.04 / $181.97
| Facility | | $17.38 | $138.04 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $16.60 / $57.54
| Professional | | $10.47 | $16.60 | $57.54 |