- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $18.62 / $44.67
| Facility | | $12.30 | $18.62 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $8.91 / $14.45
| Professional | | $6.17 | $8.91 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $25.70 / $35.48
| Facility | | $15.85 | $25.70 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $10.96 / $18.20
| Professional | | $6.76 | $10.96 | $18.20 |
- 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
- $9.77 / $9.77 / $18.62
| Facility | | $9.77 | $9.77 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $13.18 / $19.95
| Professional | | $9.77 | $13.18 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $19.95
| Facility | | $9.77 | $9.77 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $16.98
| Professional | | $9.77 | $9.77 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $13.80 / $28.84
| Facility | | $8.91 | $13.80 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $11.75 / $79.43
| Professional | | $9.77 | $11.75 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $29.51 / $40.74
| Facility | | $14.79 | $29.51 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.00 / $12.59
| Professional | | $7.41 | $10.00 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $11.75 / $15.85
| Facility | | $6.17 | $11.75 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.62 / $13.80
| Professional | | $4.17 | $5.62 | $13.80 |