- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $43.65 / $131.83
| Facility | | $10.72 | $43.65 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $22.39
| Professional | | $7.94 | $10.96 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $48.98 / $85.11
| Facility | | $19.05 | $48.98 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.94 / $14.13
| Professional | | $5.01 | $7.94 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $16.60 / $26.92
| Facility | | $13.18 | $16.60 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $15.14 / $15.14
| Facility | | $14.45 | $15.14 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $31.62 / $75.86
| Facility | | $16.98 | $31.62 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $10.47 / $23.99
| Professional | | $8.13 | $10.47 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Facility | | $75.86 | $75.86 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $28.84 / $28.84
| Professional | | $28.84 | $28.84 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $14.45 / $77.62
| Facility | | $10.72 | $14.45 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $12.88 / $25.70
| Professional | | $7.94 | $12.88 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $12.02 / $12.02
| Professional | | $10.72 | $12.02 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $14.45 / $42.66
| Facility | | $11.48 | $14.45 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $10.47 / $23.99
| Professional | | $8.13 | $10.47 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $14.45 / $17.38
| Facility | | $6.03 | $14.45 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.32 / $14.45
| Professional | | $6.03 | $8.32 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $7.41 / $14.45
| Professional | | $5.62 | $7.41 | $14.45 |