- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $21.88 / $56.23
| Facility | | $8.13 | $21.88 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $14.13
| Professional | | $7.08 | $8.91 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $37.15 / $63.10
| Facility | | $14.13 | $37.15 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.46 / $10.47
| Professional | | $5.01 | $6.46 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $20.89 / $44.67
| Facility | | $12.30 | $20.89 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $11.75 / $11.75
| Facility | | $9.33 | $11.75 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $21.88 / $52.48
| Facility | | $9.77 | $21.88 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $6.17 / $18.20
| Professional | | $5.37 | $6.17 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $70.79 / $100.00
| Facility | | $70.79 | $70.79 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $19.50 / $19.50
| Professional | | $19.50 | $19.50 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $11.75 / $23.44
| Facility | | $8.51 | $11.75 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.47 / $18.62
| Professional | | $7.08 | $10.47 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $9.77 / $9.77
| Professional | | $8.71 | $9.77 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $11.75 / $33.88
| Facility | | $8.51 | $11.75 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $6.17 / $15.14
| Professional | | $5.37 | $6.17 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $11.75 / $14.13
| Facility | | $4.90 | $11.75 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $4.90 / $9.33
| Professional | | $4.79 | $4.90 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $6.03 / $11.75
| Professional | | $4.57 | $6.03 | $11.75 |