- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $15.85 / $47.86
| Facility | | $10.96 | $15.85 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.96 / $15.85
| Professional | | $8.91 | $10.96 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $32.36 / $50.12
| Facility | | $30.90 | $32.36 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $10.72 / $12.88
| Professional | | $10.47 | $10.72 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $30.20 / $66.07
| Facility | | $9.77 | $30.20 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $8.71 / $20.42
| Professional | | $6.76 | $8.71 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $26.30 / $60.26
| Professional | | $10.00 | $26.30 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.72 / $22.39
| Facility | | $10.00 | $10.72 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $10.23
| Professional | | $9.33 | $9.33 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $16.22 / $20.89
| Facility | | $7.24 | $16.22 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $8.13 / $16.60
| Professional | | $6.61 | $8.13 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $147.91 / $147.91
| Facility | | $147.91 | $147.91 | $147.91 |