- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $40.74 / $125.89
| Facility | | $14.79 | $40.74 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $8.71 / $27.54
| Professional | | $5.01 | $8.71 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $22.91 / $25.12
| Facility | | $14.13 | $22.91 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $9.55 / $14.45
| Professional | | $4.27 | $9.55 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $19.05 / $22.39
| Professional | | $17.78 | $19.05 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $37.15 / $104.71
| Facility | | $8.71 | $37.15 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $10.47 / $20.89
| Professional | | $5.13 | $10.47 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $17.38
| Facility | | $8.71 | $8.71 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $10.23
| Professional | | $8.71 | $8.71 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $12.02 / $25.12
| Facility | | $7.41 | $12.02 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $9.55 / $79.43
| Professional | | $7.76 | $9.55 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $25.70 / $35.48
| Facility | | $12.88 | $25.70 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.76 / $10.23
| Professional | | $6.46 | $7.76 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $10.23 / $13.80
| Facility | | $3.98 | $10.23 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $12.02
| Professional | | $5.13 | $5.13 | $12.02 |