- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $23.99 / $69.18
| Facility | | $9.55 | $23.99 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.96 / $15.85
| Professional | | $7.08 | $10.96 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $8.91 / $12.88
| Professional | | $6.17 | $8.91 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $40.74 / $74.13
| Facility | | $14.13 | $40.74 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.08 / $12.88
| Professional | | $5.01 | $7.08 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $13.18 / $20.42
| Professional | | $8.91 | $13.18 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $72.44 / $72.44
| Facility | | $12.88 | $72.44 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $28.18 / $69.18
| Facility | | $14.79 | $28.18 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $9.77 / $21.38
| Professional | | $7.24 | $9.77 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $61.66 / $61.66 / $100.00
| Facility | | $61.66 | $61.66 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $25.70
| Professional | | $25.70 | $25.70 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $12.88 / $48.98
| Facility | | $9.77 | $12.88 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $11.48 / $22.91
| Professional | | $7.08 | $11.48 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $10.72 / $10.72
| Professional | | $9.55 | $10.72 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.88 / $37.15
| Facility | | $10.23 | $12.88 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $9.77 / $21.38
| Professional | | $7.24 | $9.77 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $12.88 / $15.49
| Facility | | $5.37 | $12.88 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $7.41 / $12.88
| Professional | | $5.37 | $7.41 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.61 / $12.88
| Professional | | $5.01 | $6.61 | $12.88 |