- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $32.36 / $69.18
| Facility | | $10.96 | $32.36 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $47.86
| Professional | | $8.91 | $10.96 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $40.74 / $5,011.87
| Facility | | $30.20 | $40.74 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $10.00
| Professional | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $19.95 / $44.67
| Facility | | $9.33 | $19.95 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $16.60 / $31.62
| Professional | | $7.59 | $16.60 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $12.88 / $18.62
| Professional | | $6.17 | $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
- $6.03 / $9.12 / $22.39
| Professional | | $6.03 | $9.12 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $34.67 / $61.66
| Facility | | $20.42 | $34.67 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $7.76 / $9.77
| Professional | | $5.50 | $7.76 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $17.78 / $38.90
| Facility | | $10.47 | $17.78 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $18.20
| Professional | | $8.91 | $10.96 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $12.88 / $17.38
| Facility | | $5.62 | $12.88 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $11.48 / $17.38
| Professional | | $5.62 | $11.48 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $12.88 / $15.49
| Facility | | $7.59 | $12.88 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $7.76 / $18.20
| Professional | | $5.25 | $7.76 | $18.20 |