- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $19.50 / $89.13
| Facility | | $7.76 | $19.50 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $13.18
| Professional | | $7.08 | $8.91 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $7.41
| Professional | | $7.41 | $7.41 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $38.02 / $66.07
| Facility | | $14.45 | $38.02 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.61 / $12.02
| Professional | | $5.01 | $6.61 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $18.20 / $26.92
| Facility | | $10.96 | $18.20 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $11.75
| Facility | | $11.75 | $11.75 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $22.39 / $54.95
| Facility | | $12.30 | $22.39 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $6.76 / $18.62
| Professional | | $4.90 | $6.76 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $60.26
| Facility | | $60.26 | $60.26 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $12.02 / $22.39
| Facility | | $8.51 | $12.02 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.23 / $16.98
| Professional | | $7.08 | $10.23 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $10.00
| Professional | | $9.12 | $9.12 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $12.02 / $30.20
| Facility | | $9.12 | $12.02 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $6.46 / $15.49
| Professional | | $4.90 | $6.46 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $12.02 / $14.45
| Facility | | $5.01 | $12.02 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $8.51
| Professional | | $5.01 | $5.01 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.31 / $12.02
| Professional | | $4.68 | $6.31 | $12.02 |