- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $33.88 / $56.23
| Facility | | $12.02 | $33.88 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $22.91
| Professional | | $7.94 | $10.00 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $83.18 / $5,011.87
| Facility | | $63.10 | $83.18 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $11.75
| Professional | | $10.00 | $10.00 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $19.05 / $43.65
| Facility | | $9.33 | $19.05 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $15.49 / $28.84
| Professional | | $6.92 | $15.49 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $12.88 / $18.62
| Professional | | $6.03 | $12.88 | $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
- $11.48 / $13.18 / $22.39
| Professional | | $11.48 | $13.18 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $30.90 / $43.65
| Facility | | $10.00 | $30.90 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.00 / $15.14
| Professional | | $8.91 | $10.00 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $17.78 / $70.79
| Facility | | $9.12 | $17.78 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $13.18 / $17.78
| Professional | | $9.12 | $13.18 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $12.88 / $15.49
| Facility | | $6.92 | $12.88 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $8.32 / $20.89
| Professional | | $5.50 | $8.32 | $20.89 |