- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $42.66 / $112.20
| Facility | | $16.60 | $42.66 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $15.14 / $51.29
| Professional | | $12.02 | $15.14 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $11.75 / $11.75
| Professional | | $10.00 | $11.75 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $17.78 / $30.90
| Facility | | $15.49 | $17.78 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.47 / $21.88
| Professional | | $8.32 | $10.47 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $11.48
| Facility | | $11.48 | $11.48 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $13.49 / $13.49
| Professional | | $13.49 | $13.49 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $17.78 / $20.89
| Facility | | $12.88 | $17.78 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $16.98 / $22.91
| Professional | | $10.96 | $16.98 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $21.88 / $69.18
| Facility | | $10.96 | $21.88 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.96 / $32.36
| Professional | | $8.51 | $10.96 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $33.88 / $125.89
| Facility | | $10.96 | $33.88 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $13.18 / $28.18
| Professional | | $8.51 | $13.18 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $15.14 / $20.89
| Professional | | $12.59 | $15.14 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $20.42 / $20.42
| Facility | | $20.42 | $20.42 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $17.78 / $34.67
| Professional | | $11.75 | $17.78 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $16.98 / $25.12
| Facility | | $7.08 | $16.98 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.00 / $20.42
| Professional | | $7.08 | $10.00 | $20.42 |