- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $30.90 / $181.97
| Facility | | $7.24 | $30.90 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- 25
- Typical Low / Median / Typical High
- $45.71 / $109.65 / $199.53
| Facility | 25 | $45.71 | $109.65 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $19.95 / $41.69
| Professional | | $7.08 | $19.95 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $17.38 / $31.62 / $67.61
| Professional | 25 | $17.38 | $31.62 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $22.39 / $28.84
| Professional | | $7.94 | $22.39 | $28.84 |
- 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
- $10.00 / $16.98 / $24.55
| Facility | | $10.00 | $16.98 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $16.60 / $24.55
| Professional | | $7.59 | $16.60 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $8.91
| Facility | | $8.91 | $8.91 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $21.38 / $33.88
| Professional | | $8.71 | $21.38 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $20.42 / $23.44
| Facility | | $7.59 | $20.42 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $109.65 / $169.82 / $234.42
| Facility | | $109.65 | $169.82 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $21.38 / $34.67
| Professional | | $9.12 | $21.38 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $26.92 / $489.78 / $489.78
| Facility | | $26.92 | $489.78 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $33.88 / $489.78
| Professional | | $23.99 | $33.88 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $20.89 / $37.15
| Facility | | $7.76 | $20.89 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- 25
- Typical Low / Median / Typical High
- $46.77 / $134.90 / $199.53
| Facility | 25 | $46.77 | $134.90 | $199.53 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $19.05 / $32.36
| Professional | | $7.08 | $19.05 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $16.98 / $30.90 / $67.61
| Professional | 25 | $16.98 | $30.90 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $14.79 / $33.11
| Professional | | $8.51 | $14.79 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $27.54 / $89.13
| Professional | | $8.13 | $27.54 | $89.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $20.89 / $37.15
| Facility | | $7.76 | $20.89 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $21.88 / $37.15
| Professional | | $9.33 | $21.88 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $19.05 / $34.67
| Facility | | $7.41 | $19.05 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $18.20 / $33.88
| Professional | | $8.13 | $18.20 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- 25
- Typical Low / Median / Typical High
- $22.91 / $28.84 / $60.26
| Professional | 25 | $22.91 | $28.84 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $24.55 / $29.51
| Professional | | $8.91 | $24.55 | $29.51 |