- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $40.74 / $64.57
| Facility | | $12.59 | $40.74 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.02 / $26.92
| Professional | | $8.91 | $12.02 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $85.11 / $5,011.87
| Facility | | $64.57 | $85.11 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $12.02
| Professional | | $11.75 | $11.75 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $22.91 / $51.29
| Facility | | $10.72 | $22.91 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $19.50 / $36.31
| Professional | | $8.71 | $19.50 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.71 / $21.38
| Professional | | $7.08 | $8.71 | $21.38 |
- 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
- $12.59 / $14.79 / $25.70
| Professional | | $12.59 | $14.79 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $151.36 / $169.82
| Facility | | $67.61 | $151.36 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $11.22
| Professional | | $11.22 | $11.22 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $22.91 / $51.29
| Facility | | $12.02 | $22.91 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.02 / $18.20
| Professional | | $10.00 | $12.02 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $17.38 / $17.38
| Facility | | $14.79 | $17.38 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $16.98 / $17.38
| Professional | | $13.49 | $16.98 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $14.79 / $17.78
| Facility | | $8.71 | $14.79 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $9.12 / $22.39
| Professional | | $6.31 | $9.12 | $22.39 |