- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $28.84 / $79.43
| Facility | | $10.96 | $28.84 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.02 / $19.05
| Professional | | $8.91 | $12.02 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $52.48 / $93.33
| Facility | | $20.42 | $52.48 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $8.51 / $9.55
| Professional | | $5.01 | $8.51 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $17.78
| Facility | | $15.49 | $15.49 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $33.88 / $83.18
| Facility | | $18.20 | $33.88 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $11.48 / $26.30
| Professional | | $8.91 | $11.48 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $177.83 / $177.83 / $190.55
| Facility | | $177.83 | $177.83 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $30.90 / $30.90
| Professional | | $30.90 | $30.90 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $15.49 / $57.54
| Facility | | $11.75 | $15.49 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $14.13 / $26.92
| Professional | | $8.91 | $14.13 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $12.88 / $12.88
| Professional | | $11.48 | $12.88 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $16.60 / $46.77
| Facility | | $12.30 | $16.60 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $11.48 / $25.70
| Professional | | $8.91 | $11.48 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $15.49 / $18.62
| Facility | | $6.46 | $15.49 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $8.91 / $15.49
| Professional | | $6.46 | $8.91 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.94 / $15.49
| Professional | | $6.03 | $7.94 | $15.49 |