- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $26.30 / $70.79
| Facility | | $12.02 | $26.30 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $18.20
| Professional | | $7.94 | $10.00 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $17.78 / $23.99
| Facility | | $12.59 | $17.78 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $14.45
| Professional | | $10.23 | $10.23 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $27.54 / $43.65
| Facility | | $12.59 | $27.54 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $12.59 / $18.62
| Professional | | $6.76 | $12.59 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $16.98 / $32.36
| Facility | | $12.02 | $16.98 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $16.98 / $32.36
| Professional | | $12.02 | $16.98 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $12.88 / $75.86
| Professional | | $9.77 | $12.88 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $23.99
| Facility | | $12.02 | $12.02 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $12.02 / $23.99
| Professional | | $10.96 | $12.02 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $21.38 / $33.11
| Facility | | $12.02 | $21.38 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $14.45
| Professional | | $10.96 | $10.96 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $18.20 / $32.36
| Facility | | $13.80 | $18.20 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $14.45
| Professional | | $10.23 | $10.23 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $14.45 / $14.45
| Facility | | $12.02 | $14.45 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.92 / $13.18
| Professional | | $5.13 | $6.92 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $21.88
| Professional | | $5.50 | $5.50 | $21.88 |