- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $64.57 / $141.25
| Facility | | $11.48 | $64.57 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.17 / $15.14
| Professional | | $5.13 | $6.17 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $18.20 / $24.55
| Facility | | $11.22 | $18.20 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $7.76 / $12.88
| Professional | | $4.79 | $7.76 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $15.14 / $17.78
| Professional | | $14.45 | $15.14 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $34.67 / $128.82
| Facility | | $6.92 | $34.67 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.32 / $15.49
| Professional | | $6.03 | $8.32 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $13.80
| Facility | | $6.92 | $6.92 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $13.80
| Professional | | $6.92 | $6.92 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $10.00 / $20.89
| Facility | | $6.61 | $10.00 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $8.32 / $79.43
| Professional | | $6.92 | $8.32 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $20.89 / $28.18
| Facility | | $10.23 | $20.89 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $7.08 / $8.71
| Professional | | $5.13 | $7.08 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $8.32 / $10.96
| Facility | | $4.37 | $8.32 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $3.98 / $10.23
| Professional | | $2.88 | $3.98 | $10.23 |