- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $37.15 / $64.57
| Facility | | $11.75 | $37.15 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $25.70
| Professional | | $8.91 | $10.96 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $72.44 / $97.72 / $5,011.87
| Facility | | $72.44 | $97.72 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $12.88
| Professional | | $10.72 | $10.72 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $20.89 / $46.77
| Facility | | $10.00 | $20.89 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $17.78 / $33.11
| Professional | | $7.94 | $17.78 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $10.72 / $19.95
| Professional | | $6.46 | $10.72 | $19.95 |
- 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
- $13.49 / $15.49 / $23.99
| Professional | | $13.49 | $15.49 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $44.67 / $89.13
| Facility | | $21.38 | $44.67 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $9.12 / $12.88
| Professional | | $8.32 | $9.12 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $20.89 / $48.98
| Facility | | $11.22 | $20.89 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $16.98
| Professional | | $8.91 | $10.96 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $15.49 / $15.49
| Facility | | $13.80 | $15.49 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $15.49 / $53.70
| Professional | | $12.02 | $15.49 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $13.80 / $16.60
| Facility | | $8.13 | $13.80 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $10.23 / $23.99
| Professional | | $6.17 | $10.23 | $23.99 |