- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $34.67 / $131.83
| Facility | | $11.75 | $34.67 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $10.47 / $18.20
| Professional | | $3.98 | $10.47 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $8.71
| Professional | | $7.76 | $7.76 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $12.88 / $15.14
| Facility | | $11.48 | $12.88 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $12.88 / $12.88
| Professional | | $8.51 | $12.88 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $14.45 / $33.11
| Facility | | $8.71 | $14.45 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $13.49 / $25.70
| Professional | | $6.61 | $13.49 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $24.55 / $53.70
| Facility | | $5.75 | $24.55 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $11.48
| Professional | | $7.76 | $7.76 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $4.68 / $6.46
| Professional | | $1.17 | $4.68 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $10.72 / $16.22
| Facility | | $5.50 | $10.72 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $5.62 / $18.20
| Professional | | $3.31 | $5.62 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $6.76 / $12.88
| Professional | | $5.89 | $6.76 | $12.88 |