- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $33.11 / $93.33
| Facility | | $14.45 | $33.11 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $14.13 / $19.95
| Professional | | $7.08 | $14.13 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $11.48
| Professional | | $10.23 | $10.23 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $17.38 / $20.42
| Facility | | $15.14 | $17.38 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $17.38 / $17.38
| Professional | | $13.80 | $17.38 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $19.05 / $44.67
| Facility | | $11.75 | $19.05 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $17.38 / $34.67
| Professional | | $8.71 | $17.38 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $39.81 / $87.10
| Facility | | $9.33 | $39.81 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $15.49
| Professional | | $10.23 | $10.23 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $8.32 / $10.23
| Professional | | $2.04 | $8.32 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $14.13 / $21.38
| Facility | | $7.24 | $14.13 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $7.41 / $22.91
| Professional | | $5.37 | $7.41 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $17.38
| Professional | | $10.23 | $10.23 | $17.38 |