- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $52.48 / $173.78
| Facility | | $10.72 | $52.48 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.02 / $17.38
| Professional | | $8.91 | $12.02 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $9.33 / $9.33
| Professional | | $8.13 | $9.33 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $42.66
| Facility | | $30.20 | $30.20 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $9.55 / $11.75
| Professional | | $6.03 | $9.55 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $29.51 / $61.66
| Facility | | $11.22 | $29.51 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $9.12 / $20.42
| Professional | | $7.08 | $9.12 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $27.54 / $27.54
| Professional | | $27.54 | $27.54 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $12.30 / $14.13
| Facility | | $10.72 | $12.30 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.80 / $15.14
| Professional | | $10.96 | $13.80 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $16.22 / $21.88
| Facility | | $6.76 | $16.22 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $9.12 / $18.62
| Professional | | $6.76 | $9.12 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $64.57 / $85.11
| Facility | | $64.57 | $64.57 | $85.11 |