- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $53.70 / $93.33
| Facility | | $12.02 | $53.70 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.96 / $22.91
| Professional | | $10.00 | $10.96 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $8.71 / $13.18
| Professional | | $7.41 | $8.71 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $48.98 / $48.98
| Facility | | $36.31 | $48.98 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $10.47 / $12.30
| Professional | | $10.47 | $10.47 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $28.84 / $63.10
| Facility | | $9.33 | $28.84 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $8.71 / $20.42
| Professional | | $6.46 | $8.71 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $26.30 / $44.67
| Professional | | $10.00 | $26.30 | $44.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.96 / $22.39
| Facility | | $10.00 | $10.96 | $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
- $6.92 / $14.13 / $20.89
| Facility | | $6.92 | $14.13 | $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
- $66.07 / $66.07 / $66.07
| Facility | | $66.07 | $66.07 | $66.07 |