- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $46.77 / $165.96
| Facility | | $16.60 | $46.77 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $13.49 / $43.65
| Professional | | $11.22 | $13.49 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $10.47 / $20.42
| Professional | | $7.59 | $10.47 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $15.85 / $27.54
| Facility | | $13.80 | $15.85 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.33 / $19.05
| Professional | | $7.41 | $9.33 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $10.23
| Facility | | $10.23 | $10.23 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $12.02
| Professional | | $12.02 | $12.02 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.85 / $18.62
| Facility | | $15.14 | $15.85 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $15.14 / $20.42
| Professional | | $9.77 | $15.14 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $19.50 / $61.66
| Facility | | $10.00 | $19.50 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $9.77 / $28.84
| Professional | | $7.59 | $9.77 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $52.48 / $141.25
| Facility | | $18.62 | $52.48 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $12.02 / $27.54
| Professional | | $6.03 | $12.02 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $13.49 / $18.62
| Professional | | $11.22 | $13.49 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $18.20
| Facility | | $18.20 | $18.20 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $16.22 / $33.11
| Professional | | $10.47 | $16.22 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $15.14 / $22.39
| Facility | | $8.32 | $15.14 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $13.18 / $20.89
| Professional | | $9.12 | $13.18 | $20.89 |