- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $39.81 / $87.10
| Facility | | $16.98 | $39.81 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.23 / $20.42
| Professional | | $8.91 | $10.23 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $33.11
| Facility | | $18.62 | $18.62 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.88 / $17.78
| Professional | | $10.96 | $12.88 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $25.70 / $30.20
| Professional | | $23.99 | $25.70 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $21.88 / $81.28
| Facility | | $11.48 | $21.88 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $13.18 / $19.95
| Professional | | $10.00 | $13.18 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $23.44
| Facility | | $11.48 | $11.48 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $23.44
| Professional | | $11.48 | $11.48 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $15.85 / $33.88
| Facility | | $11.22 | $15.85 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.59 / $16.22
| Professional | | $10.96 | $12.59 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $34.67 / $47.86
| Facility | | $17.38 | $34.67 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $10.47 / $13.80
| Professional | | $8.71 | $10.47 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $13.80 / $18.62
| Facility | | $5.25 | $13.80 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $4.79 / $13.80
| Professional | | $4.79 | $4.79 | $13.80 |