- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $41.69 / $104.71
| Facility | | $12.02 | $41.69 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.96 / $18.62
| Professional | | $10.00 | $10.96 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $8.51
| Professional | | $8.32 | $8.32 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $13.80 / $16.22
| Facility | | $12.02 | $13.80 | $16.22 |
- 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
- $9.55 / $14.79 / $54.95
| Facility | | $9.55 | $14.79 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $13.18 / $26.92
| Professional | | $7.24 | $13.18 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $20.42
| Professional | | $8.32 | $8.32 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $6.61 / $8.32
| Professional | | $1.66 | $6.61 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $11.22 / $16.98
| Facility | | $5.75 | $11.22 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.94 / $18.62
| Professional | | $5.75 | $7.94 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $13.80
| Professional | | $8.32 | $8.32 | $13.80 |