- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $40.74 / $114.82
| Facility | | $12.30 | $40.74 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.47 / $15.85
| Professional | | $7.41 | $10.47 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $9.12 / $9.12
| Professional | | $8.71 | $9.12 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $32.36 / $45.71
| Facility | | $25.70 | $32.36 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $8.71 / $9.33
| Professional | | $7.76 | $8.71 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $30.20 / $66.07
| Facility | | $8.91 | $30.20 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $6.76 / $19.50
| Professional | | $5.37 | $6.76 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $16.60 / $52.48
| Professional | | $7.08 | $16.60 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $10.47 / $17.78
| Facility | | $8.13 | $10.47 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $10.72 / $12.02
| Professional | | $9.33 | $10.72 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $14.13 / $16.98
| Facility | | $6.03 | $14.13 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.92 / $14.79
| Professional | | $5.75 | $6.92 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $70.79 / $85.11
| Facility | | $70.79 | $70.79 | $85.11 |