- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $60.26 / $144.54
| Facility | | $11.48 | $60.26 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $18.20
| Professional | | $8.91 | $10.96 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $7.59
| Professional | | $7.59 | $7.59 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $18.20 / $24.55
| Facility | | $12.88 | $18.20 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $10.96 / $12.30
| Professional | | $9.33 | $10.96 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $27.54 / $44.67
| Facility | | $12.88 | $27.54 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $13.18 / $19.50
| Professional | | $7.59 | $13.18 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $64.57
| Professional | | $7.94 | $10.96 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $24.55
| Facility | | $12.30 | $12.30 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $13.49 / $20.42
| Professional | | $12.30 | $13.49 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $21.38 / $33.88
| Facility | | $12.30 | $21.38 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $14.79
| Professional | | $10.96 | $10.96 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $18.62 / $32.36
| Facility | | $14.13 | $18.62 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $10.96 / $12.30
| Professional | | $9.33 | $10.96 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $14.79 / $14.79
| Facility | | $10.96 | $14.79 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $7.24 / $15.85
| Professional | | $5.13 | $7.24 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $6.31 / $22.39
| Professional | | $5.50 | $6.31 | $22.39 |