- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $41.69 / $151.36
| Facility | | $12.88 | $41.69 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $17.38
| Professional | | $7.94 | $10.00 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $7.24
| Professional | | $7.24 | $7.24 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $12.02 / $14.13
| Facility | | $10.47 | $12.02 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.02 / $16.98
| Professional | | $10.00 | $12.02 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $14.79 / $30.90
| Facility | | $8.32 | $14.79 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $10.23 / $23.99
| Professional | | $6.31 | $10.23 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $16.98
| Professional | | $7.24 | $7.24 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $5.75 / $7.24
| Professional | | $1.45 | $5.75 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $9.77 / $14.79
| Facility | | $5.01 | $9.77 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.08 / $16.60
| Professional | | $5.01 | $7.08 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $12.02
| Professional | | $7.24 | $7.24 | $12.02 |