- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $33.88 / $57.54
| Facility | | $12.30 | $33.88 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.72 / $23.99
| Professional | | $8.91 | $10.72 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $53.70 / $72.44 / $5,011.87
| Facility | | $53.70 | $72.44 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $10.23
| Professional | | $10.23 | $10.23 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $19.95 / $44.67
| Facility | | $9.33 | $19.95 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $18.20 / $34.67
| Professional | | $8.32 | $18.20 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $7.76 / $19.05
| Professional | | $6.17 | $7.76 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $13.18
| Facility | | $13.18 | $13.18 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $13.18 / $22.91
| Professional | | $10.72 | $13.18 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $26.92 / $44.67
| Facility | | $10.72 | $26.92 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.00 / $16.98
| Professional | | $8.91 | $10.00 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $13.18 / $14.79
| Facility | | $8.51 | $13.18 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $13.49 / $40.74
| Professional | | $8.51 | $13.49 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $13.18 / $15.85
| Facility | | $7.76 | $13.18 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $8.32 / $19.95
| Professional | | $5.89 | $8.32 | $19.95 |