- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $23.44 / $38.02
| Facility | | $13.49 | $23.44 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.88 / $24.55
| Professional | | $10.96 | $12.88 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $17.78 / $30.90
| Facility | | $15.49 | $17.78 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.23 / $19.50
| Professional | | $8.32 | $10.23 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $19.50
| Facility | | $11.22 | $11.22 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $22.91 / $22.91
| Professional | | $22.91 | $22.91 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $21.88 / $69.18
| Facility | | $10.96 | $21.88 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $9.55 / $28.18
| Professional | | $7.94 | $9.55 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $63.10
| Facility | | $10.96 | $10.96 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $8.91 / $17.38
| Professional | | $7.94 | $8.91 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $15.85 / $20.89
| Professional | | $12.59 | $15.85 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $19.95
| Facility | | $19.95 | $19.95 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $17.78 / $33.88
| Professional | | $11.75 | $17.78 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $16.98 / $25.12
| Facility | | $8.32 | $16.98 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $9.33 / $17.38
| Professional | | $1.07 | $9.33 | $17.38 |