- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $69.18 / $141.25
| Facility | | $25.70 | $69.18 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $18.20 / $54.95
| Professional | | $12.88 | $18.20 | $54.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $25.70 / $95.50
| Facility | | $16.60 | $25.70 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $19.50 / $46.77
| Professional | | $11.48 | $19.50 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $44.67 / $64.57
| Facility | | $36.31 | $44.67 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $23.44
| Professional | | $18.20 | $18.20 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $29.51 / $70.79
| Facility | | $14.79 | $29.51 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $20.42 / $26.92
| Professional | | $10.23 | $20.42 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $141.25 / $7,079.46
| Facility | | $20.89 | $141.25 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $28.18 / $33.11
| Professional | | $28.18 | $28.18 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $19.50 / $50.12
| Professional | | $16.60 | $19.50 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $23.44 / $41.69
| Facility | | $16.60 | $23.44 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $25.70 / $95.50
| Facility | | $16.60 | $25.70 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $19.50 / $46.77
| Professional | | $11.48 | $19.50 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $24.55 / $44.67
| Facility | | $16.98 | $24.55 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $19.05 / $28.84
| Professional | | $16.98 | $19.05 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $19.50 / $26.92
| Facility | | $9.55 | $19.50 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $15.49 / $58.88
| Professional | | $11.48 | $15.49 | $58.88 |