- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $26.30 / $81.28
| Facility | | $12.88 | $26.30 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $12.88 / $20.89
| Professional | | $5.01 | $12.88 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $20.89 / $28.18
| Facility | | $14.13 | $20.89 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $12.59 / $14.13
| Professional | | $10.47 | $12.59 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $28.84 / $36.31
| Facility | | $7.76 | $28.84 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $12.30 / $19.95
| Professional | | $4.17 | $12.30 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.30 / $64.57
| Professional | | $8.91 | $12.30 | $64.57 |
- 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 / $16.22
| Professional | | $14.13 | $14.13 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $22.39 / $38.90
| Facility | | $14.13 | $22.39 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $16.98
| Professional | | $12.59 | $12.59 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $20.89 / $37.15
| Facility | | $14.13 | $20.89 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $12.59 / $14.13
| Professional | | $10.47 | $12.59 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $16.98 / $16.98
| Facility | | $12.59 | $16.98 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $5.89 / $14.13
| Professional | | $3.47 | $5.89 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $7.24 / $25.12
| Professional | | $6.31 | $7.24 | $25.12 |