- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $26.30 / $77.62
| Facility | | $5.62 | $26.30 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $11.75 / $23.44
| Professional | | $10.00 | $11.75 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.76 / $8.71
| Professional | | $6.46 | $7.76 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $13.18 / $15.49
| Facility | | $11.48 | $13.18 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $13.18 / $18.20
| Professional | | $10.72 | $13.18 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $15.85 / $33.88
| Facility | | $9.12 | $15.85 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $13.49 / $25.70
| Professional | | $6.61 | $13.49 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $56.23 / $123.03
| Facility | | $12.88 | $56.23 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $18.20
| Professional | | $7.76 | $7.76 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $6.31 / $7.76
| Professional | | $1.58 | $6.31 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $10.72 / $16.22
| Facility | | $5.50 | $10.72 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $7.59 / $18.20
| Professional | | $5.25 | $7.59 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $13.18
| Professional | | $7.76 | $7.76 | $13.18 |