- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $69.18 / $186.21
| Facility | | $9.33 | $69.18 | $186.21 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $11.75 / $50.12
| Professional | | $6.03 | $11.75 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.89 / $6.46
| Professional | | $3.31 | $3.89 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $26.92
| Facility | | $7.76 | $7.76 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $7.94 / $19.95
| Professional | | $4.37 | $7.94 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $14.79 / $17.38
| Facility | | $11.75 | $14.79 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $14.45 / $43.65
| Facility | | $10.23 | $14.45 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $7.76 / $28.18
| Professional | | $4.47 | $7.76 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $47.86 / $120.23
| Facility | | $9.12 | $47.86 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.68 / $9.77
| Professional | | $3.24 | $4.68 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $7.76 / $9.55
| Facility | | $3.47 | $7.76 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.68 / $10.96
| Professional | | $3.24 | $4.68 | $10.96 |