- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $26.30 / $75.86
| Facility | | $11.75 | $26.30 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $10.96 / $32.36
| Professional | | $3.98 | $10.96 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $35.48
| Facility | | $13.80 | $13.80 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $8.32 / $19.95
| Professional | | $5.50 | $8.32 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $13.80 / $13.80
| Facility | | $8.32 | $13.80 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $13.80 / $13.80
| Professional | | $10.00 | $13.80 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $29.51 / $69.18
| Facility | | $13.49 | $29.51 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $16.60 / $66.07
| Professional | | $8.13 | $16.60 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $19.05 / $38.02
| Facility | | $15.85 | $19.05 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $9.55 / $26.92
| Professional | | $6.46 | $9.55 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $7.24
| Facility | | $7.24 | $7.24 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $11.75 / $22.91
| Professional | | $7.24 | $11.75 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $39.81 / $47.86
| Facility | | $27.54 | $39.81 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $25.70 / $50,118.72
| Facility | | $13.80 | $25.70 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $13.80 / $18.62
| Facility | | $8.91 | $13.80 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $9.33 / $33.11
| Professional | | $5.75 | $9.33 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $8.71 / $15.85
| Facility | | $7.24 | $8.71 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $11.75 / $20.89
| Professional | | $7.24 | $11.75 | $20.89 |