- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $20.42 / $30.90
| Professional | | $15.85 | $20.42 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $40.74 / $112.20
| Professional | | $10.00 | $40.74 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $24.55 / $30.20
| Facility | | $20.42 | $24.55 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $27.54
| Professional | | $20.42 | $20.42 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $74.13 / $109.65
| Facility | | $64.57 | $74.13 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $21.38 / $56.23
| Professional | | $10.72 | $21.38 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $24.55 / $60.26
| Facility | | $18.20 | $24.55 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $120.23 / $120.23 / $134.90
| Professional | | $120.23 | $120.23 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $35.48 / $87.10
| Facility | | $18.20 | $35.48 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $16.98 / $141.25
| Professional | | $12.02 | $16.98 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $50.12 / $70.79
| Professional | | $23.44 | $50.12 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $34.67 / $57.54
| Professional | | $20.42 | $34.67 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $35.48 / $47.86 / $70.79
| Professional | | $35.48 | $47.86 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $46.77 / $46.77 / $97.72
| Facility | | $46.77 | $46.77 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $102.33 / $144.54
| Professional | | $10.72 | $102.33 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $23.44 / $42.66
| Professional | | $23.44 | $23.44 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $100.00 / $138.04
| Professional | | $23.44 | $100.00 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $36.31 / $87.10
| Professional | | $12.02 | $36.31 | $87.10 |