- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $21.88 / $63.10
| Facility | | $17.78 | $21.88 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $12.88 / $21.88
| Professional | | $5.01 | $12.88 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $22.91 / $40.74
| Facility | | $22.91 | $22.91 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $15.49 / $25.12
| Professional | | $4.17 | $15.49 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $30.90 / $36.31
| Professional | | $28.84 | $30.90 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $14.13 / $18.20
| Facility | | $13.80 | $14.13 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $14.13 / $20.42
| Professional | | $7.59 | $14.13 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $28.18
| Facility | | $14.13 | $14.13 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $16.60
| Professional | | $14.13 | $14.13 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $19.50 / $40.74
| Facility | | $7.08 | $19.50 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $15.49 / $79.43
| Professional | | $7.59 | $15.49 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $41.69 / $54.95
| Facility | | $20.89 | $41.69 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $10.47 / $16.98
| Professional | | $5.75 | $10.47 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $16.98 / $22.39
| Facility | | $3.80 | $16.98 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $5.89 / $16.98
| Professional | | $3.39 | $5.89 | $16.98 |