- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $95.50
| Facility | | $8.91 | $8.91 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.02 / $15.85
| Professional | | $8.91 | $12.02 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $26.30 / $56.23
| Professional | | $16.60 | $26.30 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $52.48 / $83.18
| Facility | | $44.67 | $52.48 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $34.67 / $50.12
| Professional | | $14.13 | $34.67 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $34.67 / $10,471.29
| Facility | | $9.55 | $34.67 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $51.29 / $69.18
| Professional | | $18.20 | $51.29 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $15.85 / $123.03
| Facility | | $9.55 | $15.85 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $10.72 / $158.49
| Professional | | $9.55 | $10.72 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $50.12 / $70.79
| Professional | | $32.36 | $50.12 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $27.54 / $27.54
| Professional | | $27.54 | $27.54 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $35.48 / $53.70
| Professional | | $18.20 | $35.48 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $125.89
| Facility | | $85.11 | $85.11 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $26.92 / $190.55
| Professional | | $13.49 | $26.92 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $30.90 / $33.88
| Professional | | $28.84 | $30.90 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $10.00 / $18.62
| Professional | | $6.76 | $10.00 | $18.62 |