- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $20.42 / $41.69
| Facility | | $12.02 | $20.42 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $41.69
| Professional | | $7.94 | $10.96 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $6.17
| Professional | | $6.17 | $6.17 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.30 / $42.66
| Facility | | $12.30 | $12.30 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $10.96 / $28.84
| Professional | | $6.03 | $10.96 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $26.30 / $28.84
| Facility | | $24.55 | $26.30 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $12.30 / $30.20
| Professional | | $8.51 | $12.30 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $23.44 / $69.18
| Facility | | $16.22 | $23.44 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $9.12 / $21.38
| Professional | | $5.89 | $9.12 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $19.05 / $79.43
| Facility | | $10.72 | $19.05 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $9.77 / $100.00
| Professional | | $5.13 | $9.77 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $14.79 / $16.60
| Facility | | $4.37 | $14.79 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $7.41 / $16.60
| Professional | | $5.13 | $7.41 | $16.60 |