- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $38.90 / $93.33
| Facility | | $18.62 | $38.90 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $15.14 / $61.66
| Professional | | $12.02 | $15.14 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.48 / $25.12
| Professional | | $11.22 | $11.48 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $19.50 / $33.88
| Facility | | $16.98 | $19.50 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.55 / $21.38
| Professional | | $7.41 | $9.55 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $14.79 / $14.79
| Professional | | $14.79 | $14.79 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $19.50 / $22.91
| Facility | | $12.02 | $19.50 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $18.62 / $25.12
| Professional | | $12.02 | $18.62 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $23.99 / $75.86
| Facility | | $12.30 | $23.99 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.23 / $27.54
| Professional | | $8.51 | $10.23 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $37.15 / $100.00
| Facility | | $12.02 | $37.15 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.47 / $22.91
| Professional | | $7.41 | $10.47 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $16.60 / $22.91
| Professional | | $13.80 | $16.60 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $22.39 / $22.39
| Facility | | $22.39 | $22.39 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $19.50 / $38.02
| Professional | | $12.88 | $19.50 | $38.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $18.62 / $27.54
| Facility | | $7.76 | $18.62 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $11.22 / $19.05
| Professional | | $7.76 | $11.22 | $19.05 |