- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $70.79 / $208.93
| Facility | | $12.88 | $70.79 | $208.93 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $7.76 / $12.59
| Professional | | $6.31 | $7.76 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $22.91 / $30.90
| Facility | | $14.13 | $22.91 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $9.55 / $16.60
| Professional | | $6.03 | $9.55 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $19.05 / $22.39
| Professional | | $17.78 | $19.05 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $40.74 / $194.98
| Facility | | $8.71 | $40.74 | $194.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $10.72 / $14.45
| Professional | | $7.76 | $10.72 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $17.38
| Facility | | $8.71 | $8.71 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $10.72
| Professional | | $8.71 | $8.71 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $12.30 / $26.30
| Facility | | $8.32 | $12.30 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $10.23 / $79.43
| Professional | | $8.71 | $10.23 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $25.70 / $35.48
| Facility | | $12.88 | $25.70 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $8.71 / $10.96
| Professional | | $6.46 | $8.71 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $10.23 / $13.80
| Facility | | $5.37 | $10.23 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.90 / $12.88
| Professional | | $3.63 | $4.90 | $12.88 |