- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $29.51 / $107.15
| Facility | | $10.96 | $29.51 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.02 / $16.98
| Professional | | $8.91 | $12.02 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $9.12
| Professional | | $9.12 | $9.12 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $50.12 / $89.13
| Facility | | $19.50 | $50.12 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $8.13 / $14.13
| Professional | | $5.01 | $8.13 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $22.91 / $91.20
| Facility | | $13.80 | $22.91 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $15.14 / $23.44
| Professional | | $10.47 | $15.14 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $14.79 / $16.98
| Facility | | $14.79 | $14.79 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $32.36 / $79.43
| Facility | | $17.38 | $32.36 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.72 / $25.12
| Professional | | $8.51 | $10.72 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $162.18 / $162.18 / $162.18
| Facility | | $162.18 | $162.18 | $162.18 |
- 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
- $11.22 / $14.79 / $67.61
| Facility | | $11.22 | $14.79 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $13.18 / $25.70
| Professional | | $7.94 | $13.18 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $12.30 / $12.30
| Professional | | $11.22 | $12.30 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $14.79 / $43.65
| Facility | | $11.75 | $14.79 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.72 / $24.55
| Professional | | $8.51 | $10.72 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $14.79 / $17.78
| Facility | | $6.17 | $14.79 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $8.51 / $14.79
| Professional | | $6.17 | $8.51 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.59 / $10.23
| Professional | | $5.75 | $7.59 | $10.23 |