- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $69.18 / $123.03
| Facility | | $9.77 | $69.18 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $5.37 / $19.05
| Professional | | $4.47 | $5.37 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $15.85 / $21.38
| Facility | | $9.77 | $15.85 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $6.76 / $11.48
| Professional | | $4.17 | $6.76 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $13.49 / $15.49
| Professional | | $12.30 | $13.49 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $19.05 / $97.72
| Facility | | $6.03 | $19.05 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $7.59 / $11.48
| Professional | | $5.25 | $7.59 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $12.02
| Facility | | $6.03 | $6.03 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $12.02
| Professional | | $6.03 | $6.03 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $8.32 / $18.20
| Facility | | $5.89 | $8.32 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.59 / $79.43
| Professional | | $6.03 | $7.59 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $18.20 / $24.55
| Facility | | $9.12 | $18.20 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.17 / $7.59
| Professional | | $4.47 | $6.17 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $7.24 / $9.55
| Facility | | $3.80 | $7.24 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.47 / $8.71
| Professional | | $2.51 | $3.47 | $8.71 |