- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $151.36 / $398.11
| Facility | | $26.92 | $151.36 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $12.02 / $51.29
| Professional | | $5.89 | $12.02 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $23.44 / $144.54
| Facility | | $7.41 | $23.44 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $15.14 / $102.33
| Professional | | $7.41 | $15.14 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $83.18 / $100.00 / $131.83
| Facility | | $83.18 | $100.00 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $7.94
| Professional | | $7.94 | $7.94 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $109.65 / $154.88
| Facility | | $31.62 | $109.65 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $25.70 / $41.69
| Professional | | $20.89 | $25.70 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $9.12 / $85.11
| Facility | | $4.17 | $9.12 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $7.24 / $13.80
| Professional | | $4.07 | $7.24 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $13.18 / $22.39
| Professional | | $7.24 | $13.18 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $104.71 / $154.88 / $218.78
| Facility | | $104.71 | $154.88 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $7.24 / $19.05
| Professional | | $5.89 | $7.24 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $23.44 / $144.54
| Facility | | $7.41 | $23.44 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $15.14 / $102.33
| Professional | | $7.41 | $15.14 | $102.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $75.86 / $512.86
| Facility | | $5.01 | $75.86 | $512.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $8.91 / $12.02
| Professional | | $6.61 | $8.91 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $107.15 / $234.42
| Facility | | $16.22 | $107.15 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $15.85 / $29.51
| Professional | | $8.51 | $15.85 | $29.51 |