- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $25.70 / $87.10
| Facility | | $7.08 | $25.70 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $19.95
| Professional | | $6.03 | $6.03 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $17.78 / $53.70
| Facility | | $8.91 | $17.78 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $9.12 / $14.79
| Professional | | $8.13 | $9.12 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $10.96
| Facility | | $10.96 | $10.96 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $11.22
| Facility | | $11.22 | $11.22 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $15.14
| Professional | | $15.14 | $15.14 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $17.38 / $26.92
| Facility | | $15.49 | $17.38 | $26.92 |
- 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
- $6.46 / $29.51 / $74.13
| Facility | | $6.46 | $29.51 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $25.12
| Professional | | $6.46 | $6.46 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $9.33 / $15.49
| Professional | | $6.46 | $9.33 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $13.80 / $19.05
| Professional | | $7.76 | $13.80 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $26.30 / $26.30
| Facility | | $15.14 | $26.30 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $9.55
| Professional | | $6.46 | $6.46 | $9.55 |