- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $39.81 / $134.90
| Facility | | $12.02 | $39.81 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $11.22 / $26.92
| Professional | | $8.91 | $11.22 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.71 / $8.71
| Professional | | $8.32 | $8.71 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $53.70 / $53.70
| Facility | | $30.20 | $53.70 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $11.22 / $15.49
| Professional | | $8.32 | $11.22 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $28.84 / $63.10
| Facility | | $9.33 | $28.84 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $8.91 / $21.38
| Professional | | $6.46 | $8.91 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $26.92 / $48.98
| Professional | | $10.47 | $26.92 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $11.22 / $24.55
| Facility | | $10.47 | $11.22 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.47 / $11.75
| Professional | | $10.00 | $10.47 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $13.80 / $21.88
| Facility | | $6.61 | $13.80 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $8.71 / $17.78
| Professional | | $5.75 | $8.71 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |