- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $37.15 / $95.50
| Facility | | $9.12 | $37.15 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.00 / $15.14
| Professional | | $7.08 | $10.00 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $8.51 / $8.51
| Professional | | $5.89 | $8.51 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $39.81 / $70.79
| Facility | | $15.14 | $39.81 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.76 / $11.75
| Professional | | $5.01 | $6.76 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $12.30 / $19.50
| Professional | | $8.51 | $12.30 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $34.67 / $34.67
| Facility | | $12.30 | $34.67 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $26.92 / $64.57
| Facility | | $14.45 | $26.92 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $9.12 / $24.55
| Professional | | $6.92 | $9.12 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $91.20 / $91.20
| Facility | | $79.43 | $91.20 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $24.55 / $24.55
| Professional | | $24.55 | $24.55 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $12.30 / $63.10
| Facility | | $9.33 | $12.30 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.96 / $18.62
| Professional | | $7.08 | $10.96 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $10.23 / $10.23
| Professional | | $9.12 | $10.23 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $562.34 / $630.96
| Facility | | $562.34 | $562.34 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $12.30 / $37.15
| Facility | | $9.77 | $12.30 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $9.12 / $20.42
| Professional | | $6.92 | $9.12 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $12.30 / $14.79
| Facility | | $5.25 | $12.30 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $7.08 / $12.02
| Professional | | $5.13 | $7.08 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $6.31 / $12.30
| Professional | | $4.79 | $6.31 | $12.30 |