- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $35.48 / $89.13
| Facility | | $15.14 | $35.48 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.45 / $30.20
| Professional | | $12.02 | $14.45 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $17.38
| Professional | | $7.94 | $10.96 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $16.98 / $29.51
| Facility | | $14.45 | $16.98 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $9.55 / $13.80
| Professional | | $7.94 | $9.55 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $10.72
| Facility | | $10.72 | $10.72 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $16.60 / $19.95
| Facility | | $10.72 | $16.60 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $15.85 / $21.38
| Professional | | $10.23 | $15.85 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $20.89 / $66.07
| Facility | | $10.47 | $20.89 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $14.79 / $30.20
| Professional | | $8.13 | $14.79 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $28.84 / $72.44
| Facility | | $10.23 | $28.84 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $12.59 / $28.18
| Professional | | $6.31 | $12.59 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.45 / $19.50
| Professional | | $12.02 | $14.45 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $19.05 / $19.05
| Facility | | $19.05 | $19.05 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $16.60 / $37.15
| Professional | | $11.22 | $16.60 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $15.85 / $23.99
| Facility | | $7.94 | $15.85 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $15.85 / $22.91
| Professional | | $9.55 | $15.85 | $22.91 |