- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $26.92 / $239.88
| Facility | | $6.76 | $26.92 | $239.88 |
- Facility/Professional
- Facility
- Modifier
- 25
- Typical Low / Median / Typical High
- $61.66 / $218.78 / $676.08
| Facility | 25 | $61.66 | $218.78 | $676.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $21.88 / $53.70
| Professional | | $7.76 | $21.88 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $16.98 / $32.36 / $72.44
| Professional | 25 | $16.98 | $32.36 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $21.88 / $26.92
| Professional | | $7.59 | $21.88 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $18.62 / $22.91 / $25.70
| Professional | 25 | $18.62 | $22.91 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $257.04 / $363.08 / $398.11
| Facility | | $257.04 | $363.08 | $398.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.79 / $16.60 / $33.88
| Professional | | $0.79 | $16.60 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $128.82
| Facility | | $12.59 | $12.59 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $31.62
| Professional | | $12.59 | $12.59 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $109.65 / $245.47
| Facility | | $27.54 | $109.65 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $23.99 / $48.98
| Professional | | $9.77 | $23.99 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.10 / $0.10 / $25.12
| Facility | | $0.10 | $0.10 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- 25
- Typical Low / Median / Typical High
- $0.10 / $0.10 / $0.10
| Facility | 25 | $0.10 | $0.10 | $0.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $23.99 / $39.81
| Professional | | $18.20 | $23.99 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $36.31
| Facility | | $20.42 | $20.42 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $25.70 / $48.98
| Professional | | $17.78 | $25.70 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $14.79 / $26.92
| Professional | | $7.24 | $14.79 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $21.38 / $28.18 / $44.67
| Professional | 25 | $21.38 | $28.18 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $50.12 / $112.20
| Facility | | $26.30 | $50.12 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- 25
- Typical Low / Median / Typical High
- $83.18 / $83.18 / $104.71
| Facility | 25 | $83.18 | $83.18 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $26.92 / $54.95
| Professional | | $20.89 | $26.92 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $21.38 / $21.88 / $34.67
| Professional | 25 | $21.38 | $21.88 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $31.62 / $51.29
| Professional | | $26.30 | $31.62 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $26.92 / $44.67
| Professional | | $22.39 | $26.92 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $22.91 / $38.02
| Facility | | $19.50 | $22.91 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $26.92 / $64.57
| Professional | | $19.95 | $26.92 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $24.55 / $33.11 / $79.43
| Professional | 25 | $24.55 | $33.11 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $20.42 / $51.29
| Facility | | $8.91 | $20.42 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $24.55 / $45.71
| Professional | | $17.78 | $24.55 | $45.71 |