- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $26.92 / $204.17
| Facility | | $10.23 | $26.92 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $16.98
| Professional | | $7.94 | $10.96 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $9.55
| Professional | | $8.32 | $8.32 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $46.77 / $83.18
| Facility | | $18.20 | $46.77 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.59 / $13.18
| Professional | | $5.01 | $7.59 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $13.80 / $20.42
| Professional | | $9.55 | $13.80 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $13.80 / $15.85
| Facility | | $13.80 | $13.80 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $30.20 / $69.18
| Facility | | $12.30 | $30.20 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $9.33 / $22.91
| Professional | | $7.76 | $9.33 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $85.11 / $85.11
| Facility | | $64.57 | $85.11 | $85.11 |
- 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
- $10.00 / $13.80 / $58.88
| Facility | | $10.00 | $13.80 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $12.30 / $21.88
| Professional | | $7.94 | $12.30 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $11.48 / $11.48
| Professional | | $10.23 | $11.48 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $13.80 / $39.81
| Facility | | $10.00 | $13.80 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $9.33 / $20.89
| Professional | | $7.76 | $9.33 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $13.80 / $16.60
| Facility | | $6.17 | $13.80 | $16.60 |
- 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
- $5.37 / $7.08 / $9.55
| Professional | | $5.37 | $7.08 | $9.55 |