- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $30.20 / $83.18
| Facility | | $12.02 | $30.20 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $12.02 / $18.20
| Professional | | $8.71 | $12.02 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $51.29 / $87.10
| Facility | | $19.50 | $51.29 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $8.71 / $21.38
| Professional | | $5.50 | $8.71 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $15.85 / $15.85
| Facility | | $13.80 | $15.85 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $28.84 / $69.18
| Facility | | $14.13 | $28.84 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $8.91 / $23.99
| Professional | | $7.76 | $8.91 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $75.86 / $75.86 / $75.86
| Facility | | $75.86 | $75.86 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $25.70 / $25.70
| Professional | | $25.70 | $25.70 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $15.85 / $44.67
| Facility | | $9.55 | $15.85 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $14.45 / $25.12
| Professional | | $8.91 | $14.45 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $13.49 / $13.49
| Professional | | $12.02 | $13.49 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $15.85 / $46.77
| Facility | | $8.91 | $15.85 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $8.91 / $20.89
| Professional | | $7.76 | $8.91 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $15.85 / $19.05
| Facility | | $6.76 | $15.85 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $7.08 / $16.60
| Professional | | $6.76 | $7.08 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $8.32 / $15.85
| Professional | | $6.31 | $8.32 | $15.85 |