- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $39.81 / $67.61
| Facility | | $14.45 | $39.81 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.88 / $26.92
| Professional | | $10.00 | $12.88 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $102.33 / $5,011.87
| Facility | | $77.62 | $102.33 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $14.45
| Professional | | $12.02 | $12.02 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $23.44 / $52.48
| Facility | | $10.96 | $23.44 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $21.38 / $38.90
| Professional | | $8.71 | $21.38 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $12.59 / $22.39
| Professional | | $7.24 | $12.59 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $15.14
| Facility | | $15.14 | $15.14 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $16.22 / $26.30
| Professional | | $14.13 | $16.22 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $38.02 / $52.48
| Facility | | $12.30 | $38.02 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.88 / $23.44
| Professional | | $10.96 | $12.88 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $15.14 / $37.15
| Facility | | $5.75 | $15.14 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $16.22 / $25.12
| Professional | | $6.76 | $16.22 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $15.14 / $18.20
| Facility | | $8.91 | $15.14 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $13.80 / $25.70
| Professional | | $9.12 | $13.80 | $25.70 |