- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $56.23 / $234.42
| Facility | | $10.00 | $56.23 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $9.12 / $21.88
| Professional | | $7.94 | $9.12 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $7.08 / $18.62
| Professional | | $6.31 | $7.08 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $15.14 / $20.42
| Facility | | $10.72 | $15.14 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $9.12 / $10.23
| Professional | | $7.59 | $9.12 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $22.39 / $36.31
| Facility | | $10.47 | $22.39 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $10.72 / $15.85
| Professional | | $6.31 | $10.72 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $8.91 / $10.72
| Professional | | $6.46 | $8.91 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $20.42
| Facility | | $10.23 | $10.23 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $10.23 / $11.22
| Professional | | $9.12 | $10.23 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $17.78 / $28.18
| Facility | | $10.23 | $17.78 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $12.30
| Professional | | $9.12 | $9.12 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $15.14 / $26.92
| Facility | | $11.75 | $15.14 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $9.12 / $10.23
| Professional | | $7.59 | $9.12 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $12.30 / $12.30
| Facility | | $9.12 | $12.30 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $6.03 / $14.13
| Professional | | $4.27 | $6.03 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.25 / $18.20
| Professional | | $4.57 | $5.25 | $18.20 |