- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $42.66 / $162.18
| Facility | | $11.22 | $42.66 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.72 / $17.38
| Professional | | $8.91 | $10.72 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $8.32
| Professional | | $8.32 | $8.32 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $17.38 / $23.44
| Facility | | $12.30 | $17.38 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.72 / $11.75
| Professional | | $8.91 | $10.72 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $26.30 / $38.90
| Facility | | $12.30 | $26.30 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $12.59 / $19.05
| Professional | | $7.24 | $12.59 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $10.47 / $64.57
| Professional | | $7.59 | $10.47 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $23.99
| Facility | | $11.75 | $11.75 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $14.13
| Professional | | $11.75 | $11.75 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $20.89 / $32.36
| Facility | | $11.75 | $20.89 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $14.13
| Professional | | $10.72 | $10.72 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $17.78 / $31.62
| Facility | | $13.49 | $17.78 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.72 / $11.75
| Professional | | $8.91 | $10.72 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $14.13 / $14.13
| Facility | | $10.72 | $14.13 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.92 / $15.14
| Professional | | $5.01 | $6.92 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $6.17 / $21.38
| Professional | | $5.37 | $6.17 | $21.38 |