- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $33.11 / $107.15
| Facility | | $12.59 | $33.11 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $33.11
| Professional | | $8.91 | $10.96 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $12.88 / $22.91
| Facility | | $11.22 | $12.88 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.59 / $15.49
| Professional | | $6.03 | $7.59 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $12.88 / $15.49
| Facility | | $8.32 | $12.88 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $12.30 / $16.60
| Professional | | $7.94 | $12.30 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $15.49 / $50.12
| Facility | | $8.13 | $15.49 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $8.13 / $23.44
| Professional | | $6.31 | $8.13 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $33.11 / $83.18
| Facility | | $7.94 | $33.11 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $8.13 / $16.98
| Professional | | $6.31 | $8.13 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $10.96 / $15.14
| Professional | | $9.33 | $10.96 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $14.79 / $14.79
| Facility | | $14.79 | $14.79 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $12.88 / $25.12
| Professional | | $8.71 | $12.88 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $12.30 / $18.62
| Facility | | $5.13 | $12.30 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $7.41 / $16.98
| Professional | | $5.13 | $7.41 | $16.98 |