- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $25.70 / $69.18
| Facility | | $11.48 | $25.70 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.94 / $13.49
| Professional | | $6.03 | $7.94 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $23.99 / $30.20
| Facility | | $14.79 | $23.99 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $10.23 / $16.60
| Professional | | $5.75 | $10.23 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $19.95 / $22.91
| Professional | | $18.62 | $19.95 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $16.98
| Facility | | $9.12 | $9.12 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $11.48 / $14.13
| Professional | | $9.12 | $11.48 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $18.20
| Facility | | $9.12 | $9.12 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $16.98
| Professional | | $9.12 | $9.12 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.88 / $26.92
| Facility | | $8.91 | $12.88 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.96 / $79.43
| Professional | | $8.32 | $10.96 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $27.54 / $37.15
| Facility | | $13.49 | $27.54 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $8.51 / $10.96
| Professional | | $6.76 | $8.51 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $10.96 / $14.45
| Facility | | $5.25 | $10.96 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.79 / $11.75
| Professional | | $3.80 | $4.79 | $11.75 |