- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.96 / $23.99
| Facility | | $8.51 | $10.96 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $10.96 / $14.13
| Professional | | $7.24 | $10.96 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $12.30
| Professional | | $12.02 | $12.02 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $17.78 / $46.77
| Facility | | $13.49 | $17.78 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $8.13
| Professional | | $8.13 | $8.13 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $79.43
| Facility | | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $27.54
| Facility | | $10.23 | $10.23 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $8.71
| Professional | | $8.71 | $8.71 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $85.11 / $85.11
| Facility | | $81.28 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $128.82 / $128.82
| Professional | | $87.10 | $128.82 | $128.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.14 / $25.70
| Facility | | $10.00 | $15.14 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.96 / $16.60
| Professional | | $7.94 | $10.96 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $13.49
| Professional | | $11.75 | $11.75 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $24.55 / $33.88
| Professional | | $13.80 | $24.55 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $14.79 / $25.70
| Facility | | $10.00 | $14.79 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $8.71
| Professional | | $8.71 | $8.71 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $6.92 / $10.47
| Facility | | $4.90 | $6.92 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.94 / $10.47
| Professional | | $6.03 | $7.94 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $17.38 / $17.38
| Professional | | $15.85 | $17.38 | $17.38 |