- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $26.30 / $13,803.84
| Facility | | $12.02 | $26.30 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.02 / $13.80
| Professional | | $12.02 | $12.02 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $23.44 / $39.81
| Facility | | $11.75 | $23.44 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $19.50
| Professional | | $11.75 | $11.75 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $20.89 / $30.90
| Professional | | $18.20 | $20.89 | $30.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $21.88 / $28.84
| Facility | | $16.22 | $21.88 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $11.75
| Professional | | $11.75 | $11.75 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $12.59 / $20.42
| Professional | | $9.77 | $12.59 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $21.88
| Facility | | $12.59 | $12.59 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.18 / $16.98
| Facility | | $10.96 | $13.18 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.18 / $16.98
| Professional | | $10.96 | $13.18 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $15.49 / $27.54
| Facility | | $11.75 | $15.49 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.59 / $16.22
| Professional | | $12.02 | $12.59 | $16.22 |