- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $15.14 / $43.65
| Facility | | $11.48 | $15.14 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.91 / $14.45
| Professional | | $6.03 | $8.91 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $25.70 / $28.18
| Facility | | $15.85 | $25.70 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $10.72 / $17.78
| Professional | | $5.01 | $10.72 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $21.38 / $24.55
| Professional | | $19.95 | $21.38 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.77 / $18.20
| Facility | | $9.33 | $9.77 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $11.75 / $14.45
| Professional | | $9.77 | $11.75 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $19.50
| Facility | | $9.77 | $9.77 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $11.75
| Professional | | $9.77 | $9.77 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $13.49 / $28.84
| Facility | | $8.71 | $13.49 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $10.72 / $79.43
| Professional | | $8.71 | $10.72 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $28.84 / $39.81
| Facility | | $14.45 | $28.84 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $8.91 / $11.75
| Professional | | $7.24 | $8.91 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $11.75 / $15.49
| Facility | | $4.47 | $11.75 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.07 / $11.75
| Professional | | $4.07 | $4.07 | $11.75 |