- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $35.48 / $77.62
| Facility | | $10.96 | $35.48 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $21.88
| Professional | | $8.91 | $10.96 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $7.94
| Professional | | $7.94 | $7.94 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $63.10 / $1,023.29
| Facility | | $23.44 | $63.10 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $91.20 / $5,011.87
| Facility | | $67.61 | $91.20 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $11.22
| Professional | | $10.00 | $10.00 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $19.50 / $43.65
| Facility | | $9.33 | $19.50 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $16.60 / $31.62
| Professional | | $7.59 | $16.60 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.59 / $18.62
| Professional | | $6.03 | $7.59 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $12.88 / $12.88
| Facility | | $12.88 | $12.88 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $14.45 / $22.39
| Professional | | $12.59 | $14.45 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $39.81 / $70.79
| Facility | | $20.42 | $39.81 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $8.71 / $12.59
| Professional | | $7.76 | $8.71 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.44 / $53.70 / $776.25
| Facility | | $23.44 | $53.70 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.14 / $38.02
| Facility | | $10.00 | $15.14 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.00 / $16.98
| Professional | | $8.91 | $10.00 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $12.88
| Facility | | $11.22 | $11.22 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $12.88 / $21.38
| Professional | | $10.23 | $12.88 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $12.88 / $15.49
| Facility | | $7.08 | $12.88 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $9.77 / $22.39
| Professional | | $5.75 | $9.77 | $22.39 |