- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $57.54 / $114.82
| Facility | | $5.01 | $57.54 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $12.88 / $52.48
| Professional | | $5.25 | $12.88 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $34.67
| Professional | 25 | $5.50 | $5.50 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.79 / $7.08
| Professional | | $3.63 | $4.79 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $10.72 / $21.88
| Professional | | $4.68 | $10.72 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $46.77 / $46.77
| Facility | | $46.77 | $46.77 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $6.46 / $10.96
| Professional | | $4.57 | $6.46 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $7.94
| Professional | | $3.98 | $5.01 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $6.76 / $10.00
| Professional | | $4.79 | $6.76 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.75 / $8.51
| Professional | | $4.27 | $5.75 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $85.11 / $85.11
| Facility | | $70.79 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $40.74 / $40.74
| Professional | | $29.51 | $40.74 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $32.36 / $60.26
| Professional | | $6.31 | $32.36 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $6.76
| Professional | | $6.76 | $6.76 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.75 / $9.12
| Facility | | $4.37 | $5.75 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $8.32
| Professional | | $3.98 | $5.01 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $16.22
| Professional | | $16.22 | $16.22 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $6.17 / $7.59
| Professional | | $5.50 | $6.17 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $5.37
| Facility | | $5.37 | $5.37 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.89 / $22.91
| Professional | | $4.07 | $5.89 | $22.91 |