- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $35.48 / $186.21
| Facility | | $10.47 | $35.48 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $16.22
| Professional | | $7.94 | $10.00 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $5.75
| Professional | | $5.75 | $5.75 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $11.48 / $13.49
| Facility | | $10.23 | $11.48 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $11.48 / $16.22
| Professional | | $9.55 | $11.48 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $14.13 / $29.51
| Facility | | $8.13 | $14.13 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $12.02 / $23.44
| Professional | | $6.17 | $12.02 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $50.12 / $109.65
| Facility | | $11.48 | $50.12 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $16.22
| Professional | | $6.92 | $6.92 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.38 / $5.62 / $7.76
| Professional | | $1.38 | $5.62 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $9.55 / $14.45
| Facility | | $4.90 | $9.55 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $6.76 / $16.22
| Professional | | $4.90 | $6.76 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $11.48
| Professional | | $7.76 | $7.76 | $11.48 |