- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $33.88 / $87.10
| Facility | | $12.88 | $33.88 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $13.49 / $20.89
| Professional | | $10.00 | $13.49 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $57.54 / $100.00
| Facility | | $21.88 | $57.54 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $10.00 / $18.20
| Professional | | $5.01 | $10.00 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $18.20 / $18.20
| Facility | | $15.14 | $18.20 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $33.88 / $81.28
| Facility | | $15.49 | $33.88 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $9.55 / $28.18
| Professional | | $8.32 | $9.55 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $89.13 / $114.82
| Facility | | $89.13 | $89.13 | $114.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $30.20 / $30.20
| Professional | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $18.20 / $48.98
| Facility | | $13.18 | $18.20 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $16.60 / $28.84
| Professional | | $10.00 | $16.60 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $15.14 / $15.14
| Professional | | $13.80 | $15.14 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $18.20 / $53.70
| Facility | | $13.18 | $18.20 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $9.55 / $23.44
| Professional | | $8.32 | $9.55 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $18.20 / $21.88
| Facility | | $7.24 | $18.20 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.76 / $13.80
| Professional | | $7.59 | $7.76 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $9.33 / $18.20
| Professional | | $7.08 | $9.33 | $18.20 |