- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $40.74 / $114.82
| Facility | | $9.33 | $40.74 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $7.94 / $23.99
| Professional | | $6.17 | $7.94 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.37 / $6.03
| Professional | | $4.37 | $5.37 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $8.71 / $10.23
| Facility | | $7.76 | $8.71 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $8.71 / $12.88
| Professional | | $7.24 | $8.71 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $10.72 / $22.39
| Facility | | $6.17 | $10.72 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $9.33 / $16.60
| Professional | | $4.68 | $9.33 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $37.15 / $83.18
| Facility | | $8.71 | $37.15 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $12.30
| Professional | | $5.25 | $5.25 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.05 / $4.17 / $5.25
| Professional | | $1.05 | $4.17 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $7.08 / $10.72
| Facility | | $3.63 | $7.08 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $5.13 / $12.30
| Professional | | $3.09 | $5.13 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $8.71
| Professional | | $5.25 | $5.25 | $8.71 |