- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $30.20 / $51.29
| Facility | | $18.20 | $30.20 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.45 / $53.70
| Professional | | $14.13 | $14.45 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $15.49 / $26.30
| Facility | | $11.75 | $15.49 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $14.79 / $138.04
| Professional | | $10.96 | $14.79 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $77.62 / $141.25
| Facility | | $52.48 | $77.62 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $17.78 / $47.86
| Professional | | $14.45 | $17.78 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $17.78 / $25.12
| Facility | | $12.88 | $17.78 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $14.79
| Professional | | $10.96 | $10.96 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.17 / $5.62
| Professional | | $4.17 | $4.17 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $14.45 / $27.54
| Professional | | $10.72 | $14.45 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $263.03 / $263.03 / $263.03
| Facility | | $263.03 | $263.03 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3,090.30 / $3,090.30 / $3,090.30
| Professional | | $3,090.30 | $3,090.30 | $3,090.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.51 / $8.51
| Professional | | $8.51 | $8.51 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $15.85 / $158.49
| Facility | | $10.96 | $15.85 | $158.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $60.26
| Professional | | $10.96 | $10.96 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $93.33 / $93.33 / $93.33
| Professional | | $93.33 | $93.33 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $12.02 / $18.62
| Professional | | $8.71 | $12.02 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $218.78 / $218.78
| Facility | | $10.96 | $218.78 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $14.79 / $22.39
| Professional | | $13.49 | $14.79 | $22.39 |