- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $23.99 / $43.65
| Facility | | $12.30 | $23.99 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.91 / $15.14
| Professional | | $6.03 | $8.91 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $25.70 / $31.62
| Facility | | $15.85 | $25.70 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $10.96 / $17.78
| Professional | | $6.03 | $10.96 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $21.38 / $24.55
| Professional | | $19.95 | $21.38 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $27.54
| Facility | | $9.77 | $9.77 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $12.02 / $17.38
| Professional | | $9.77 | $12.02 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $19.50
| Facility | | $9.77 | $9.77 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $18.20
| Professional | | $9.77 | $9.77 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $13.49 / $28.84
| Facility | | $8.71 | $13.49 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $11.48 / $79.43
| Professional | | $8.71 | $11.48 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $29.51 / $40.74
| Facility | | $14.79 | $29.51 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $8.91 / $11.75
| Professional | | $7.41 | $8.91 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $11.75 / $15.49
| Facility | | $5.50 | $11.75 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.01 / $12.30
| Professional | | $4.07 | $5.01 | $12.30 |