- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $50.12 / $169.82
| Facility | | $9.33 | $50.12 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $8.91 / $20.89
| Professional | | $7.76 | $8.91 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.31 / $7.24
| Professional | | $6.17 | $6.31 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $10.23 / $12.02
| Facility | | $9.12 | $10.23 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.23 / $15.14
| Professional | | $8.51 | $10.23 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $12.59 / $26.30
| Facility | | $7.24 | $12.59 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $10.72 / $20.89
| Professional | | $5.50 | $10.72 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $43.65 / $95.50
| Facility | | $10.23 | $43.65 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $14.45
| Professional | | $6.17 | $6.17 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.23 / $5.01 / $6.17
| Professional | | $1.23 | $5.01 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $8.51 / $12.88
| Facility | | $4.37 | $8.51 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.03 / $14.45
| Professional | | $4.37 | $6.03 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $10.23
| Professional | | $6.17 | $6.17 | $10.23 |