- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $44.67 / $134.90
| Facility | | $11.22 | $44.67 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.00 / $29.51
| Professional | | $8.32 | $10.00 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $7.76 / $7.76
| Professional | | $6.92 | $7.76 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $16.60 / $22.39
| Facility | | $11.75 | $16.60 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.00 / $11.22
| Professional | | $8.51 | $10.00 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $25.12 / $36.31
| Facility | | $11.75 | $25.12 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $11.75 / $17.78
| Professional | | $6.92 | $11.75 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $10.00 / $64.57
| Professional | | $7.24 | $10.00 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $22.91
| Facility | | $11.22 | $11.22 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $18.62
| Professional | | $11.22 | $11.22 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $19.50 / $30.90
| Facility | | $11.22 | $19.50 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $13.49
| Professional | | $10.23 | $10.23 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $16.98 / $29.51
| Facility | | $12.88 | $16.98 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.00 / $11.22
| Professional | | $8.51 | $10.00 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $13.49 / $13.49
| Facility | | $10.23 | $13.49 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.61 / $14.45
| Professional | | $4.68 | $6.61 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.89 / $20.42
| Professional | | $5.13 | $5.89 | $20.42 |