- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $162.18 / $562.34
| Facility | | $16.60 | $162.18 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $11.48 / $53.70
| Professional | | $6.46 | $11.48 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $11.48 / $15.85
| Professional | | $6.92 | $11.48 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $162.18 / $331.13
| Facility | | $120.23 | $162.18 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $12.02 / $17.78
| Professional | | $7.76 | $12.02 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $21.38 / $30.90
| Professional | | $17.78 | $21.38 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $13.18 / $56.23
| Facility | | $8.91 | $13.18 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $12.59 / $17.38
| Professional | | $8.51 | $12.59 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $33.11
| Professional | | $32.36 | $32.36 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $12.30 / $16.22
| Facility | | $10.47 | $12.30 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $10.47 / $12.59
| Professional | | $10.47 | $10.47 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $8.71
| Facility | | $8.13 | $8.13 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $12.30 / $18.20
| Professional | | $8.71 | $12.30 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $112.20 / $169.82 / $331.13
| Facility | | $112.20 | $169.82 | $331.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $11.75 / $17.78
| Professional | | $7.76 | $11.75 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $165.96 / $218.78 / $398.11
| Facility | | $165.96 | $218.78 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $14.13 / $23.44
| Professional | | $8.71 | $14.13 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $8.51 / $16.22
| Professional | | $7.24 | $8.51 | $16.22 |