- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $43.65 / $95.50
| Facility | | $12.30 | $43.65 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.94 / $58.88
| Professional | | $6.03 | $7.94 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $5.50
| Professional | | $5.50 | $5.50 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $20.89 / $44.67
| Facility | | $5.13 | $20.89 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $7.94 / $28.84
| Professional | | $4.37 | $7.94 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $63.10 / $138.04
| Facility | | $19.95 | $63.10 | $138.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.23 / $28.18
| Professional | | $7.08 | $10.23 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $15.85 / $33.11
| Facility | | $6.76 | $15.85 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $10.23 / $22.91
| Professional | | $5.25 | $10.23 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $8.91 / $14.45
| Professional | | $7.94 | $8.91 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $20.42
| Professional | | $7.08 | $8.91 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $100.00 / $100.00
| Facility | | $70.79 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $10.72
| Professional | | $5.37 | $5.37 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.72 / $27.54
| Facility | | $7.41 | $10.72 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $8.13 / $22.91
| Professional | | $5.25 | $8.13 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $31.62 / $31.62
| Professional | | $31.62 | $31.62 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $9.12 / $15.14
| Professional | | $7.08 | $9.12 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.17 / $8.91
| Facility | | $3.98 | $6.17 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $5.37 / $18.62
| Professional | | $3.72 | $5.37 | $18.62 |