- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $31.62 / $104.71
| Facility | | $10.72 | $31.62 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.96 / $18.20
| Professional | | $10.00 | $10.96 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $8.32
| Professional | | $6.76 | $6.76 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $13.49 / $15.85
| Facility | | $12.02 | $13.49 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $13.49 / $19.05
| Professional | | $11.22 | $13.49 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $16.60 / $34.67
| Facility | | $9.33 | $16.60 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $13.18 / $26.92
| Professional | | $6.76 | $13.18 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $57.54 / $128.82
| Facility | | $13.49 | $57.54 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $19.05
| Professional | | $8.13 | $8.13 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $6.46 / $8.51
| Professional | | $1.62 | $6.46 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $10.96 / $16.60
| Facility | | $5.62 | $10.96 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $7.94 / $19.05
| Professional | | $5.25 | $7.94 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.51 / $13.49
| Professional | | $8.51 | $8.51 | $13.49 |