- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $33.88 / $9,120.11
| Facility | | $13.49 | $33.88 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $13.18 / $112.20
| Professional | | $12.88 | $13.18 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.13 / $5,011.87
| Facility | | $12.02 | $14.13 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $13.49
| Professional | | $13.49 | $13.49 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $47.86 / $51.29
| Facility | | $13.80 | $47.86 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $13.80
| Professional | | $13.80 | $13.80 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $13.80
| Facility | | $13.80 | $13.80 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $23.99 / $23.99
| Professional | | $20.42 | $23.99 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $52.48 / $75.86 / $245.47
| Facility | | $52.48 | $75.86 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $20.89 / $74.13
| Facility | | $13.80 | $20.89 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $12.88 / $20.42
| Professional | | $12.88 | $12.88 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $32.36 / $38.02
| Facility | | $28.18 | $32.36 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $32.36 / $38.02
| Professional | | $28.18 | $32.36 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $13.80
| Facility | | $13.80 | $13.80 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $14.79 / $24.55
| Professional | | $13.18 | $14.79 | $24.55 |