- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $51.29 / $147.91
| Facility | | $8.71 | $51.29 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $8.91 / $29.51
| Professional | | $7.41 | $8.91 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $7.24 / $33.11
| Professional | | $6.92 | $7.24 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $44.67 / $44.67
| Facility | | $21.88 | $44.67 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $9.33 / $11.75
| Professional | | $7.76 | $9.33 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $21.38 / $46.77
| Facility | | $7.08 | $21.38 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $7.24 / $15.85
| Professional | | $5.37 | $7.24 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $19.95 / $39.81
| Professional | | $8.51 | $19.95 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $9.33 / $20.42
| Facility | | $8.32 | $9.33 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $15.85 / $17.38
| Professional | | $8.32 | $15.85 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $10.23 / $18.20
| Facility | | $5.37 | $10.23 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $7.24 / $14.45
| Professional | | $5.13 | $7.24 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $63.10 / $63.10 / $100.00
| Facility | | $63.10 | $63.10 | $100.00 |