- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $28.18 / $77.62
| Facility | | $10.96 | $28.18 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.02 / $18.20
| Professional | | $8.91 | $12.02 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $10.47 / $10.47
| Professional | | $10.47 | $10.47 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $48.98 / $85.11
| Facility | | $17.78 | $48.98 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $8.32 / $14.79
| Professional | | $5.01 | $8.32 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.14 / $15.14
| Facility | | $10.00 | $15.14 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $31.62 / $70.79
| Facility | | $16.98 | $31.62 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.96 / $30.20
| Professional | | $8.51 | $10.96 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $79.43
| Facility | | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $30.20
| Professional | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $15.14 / $39.81
| Facility | | $11.22 | $15.14 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $13.49 / $23.99
| Professional | | $8.91 | $13.49 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $12.59 / $12.59
| Professional | | $11.22 | $12.59 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $15.14 / $43.65
| Facility | | $12.02 | $15.14 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.96 / $25.12
| Professional | | $8.51 | $10.96 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $15.14 / $18.20
| Facility | | $6.76 | $15.14 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $12.30 / $15.14
| Professional | | $9.12 | $12.30 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $7.76 / $15.14
| Professional | | $5.89 | $7.76 | $15.14 |