- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $29.51 / $77.62
| Facility | | $11.22 | $29.51 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.02 / $18.20
| Professional | | $8.91 | $12.02 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $15.85 / $15.85
| Facility | | $9.33 | $15.85 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $30.90 / $77.62
| Facility | | $15.49 | $30.90 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $9.55 / $23.99
| Professional | | $8.13 | $9.55 | $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
- $26.30 / $26.30 / $26.30
| Professional | | $26.30 | $26.30 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $15.85 / $34.67
| Facility | | $11.48 | $15.85 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $14.45 / $23.44
| Professional | | $8.91 | $14.45 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $13.49 / $33.11
| Professional | | $12.02 | $13.49 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $15.85 / $44.67
| Facility | | $11.22 | $15.85 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $9.55 / $21.88
| Professional | | $8.13 | $9.55 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $15.85 / $19.05
| Facility | | $6.76 | $15.85 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $7.76 / $13.18
| Professional | | $6.76 | $7.76 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $8.32 / $10.96
| Professional | | $6.31 | $8.32 | $10.96 |