- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $52.48 / $128.82
| Facility | | $10.96 | $52.48 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $12.02 / $17.38
| Professional | | $7.94 | $12.02 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $10.00
| Professional | | $6.92 | $6.92 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $45.71 / $83.18
| Facility | | $15.85 | $45.71 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.94 / $14.45
| Professional | | $5.01 | $7.94 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $14.45
| Facility | | $14.13 | $14.13 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $30.20 / $72.44
| Facility | | $16.22 | $30.20 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $10.47 / $23.99
| Professional | | $8.13 | $10.47 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $79.43
| Facility | | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $28.84 / $28.84
| Professional | | $28.84 | $28.84 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $14.45 / $74.13
| Facility | | $10.96 | $14.45 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $12.88 / $25.70
| Professional | | $7.94 | $12.88 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $12.02 / $12.02
| Professional | | $10.72 | $12.02 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $14.45 / $42.66
| Facility | | $11.48 | $14.45 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $10.47 / $23.99
| Professional | | $8.13 | $10.47 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $14.45 / $17.38
| Facility | | $6.03 | $14.45 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.32 / $14.13
| Professional | | $6.03 | $8.32 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $7.41 / $10.00
| Professional | | $5.62 | $7.41 | $10.00 |