- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $60.26 / $81.28
| Facility | | $9.55 | $60.26 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $10.00 / $21.88
| Professional | | $3.02 | $10.00 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $6.46 / $10.72
| Professional | | $5.50 | $6.46 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $25.70 / $52.48
| Facility | | $19.05 | $25.70 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $6.61 / $7.08
| Professional | | $4.57 | $6.61 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $8.32 / $10.23
| Professional | | $4.37 | $8.32 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $50.12 / $70.79
| Facility | | $5.62 | $50.12 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $4.27 / $5.13
| Professional | | $2.57 | $4.27 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $8.71
| Professional | | $4.37 | $4.37 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $4.37
| Facility | | $4.37 | $4.37 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $64.57 / $64.57
| Facility | | $54.95 | $64.57 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $2.57 / $5.13
| Facility | | $1.78 | $2.57 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $4.27 / $5.13
| Professional | | $2.57 | $4.27 | $5.13 |