- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $30.90 / $93.33
| Facility | | $8.71 | $30.90 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $9.77
| Professional | | $6.03 | $6.03 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $18.20 / $54.95
| Facility | | $9.12 | $18.20 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $9.33 / $14.79
| Professional | | $8.51 | $9.33 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $11.48 / $11.48
| Facility | | $11.48 | $11.48 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $7.41
| Facility | | $7.41 | $7.41 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $10.00
| Professional | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $18.20 / $28.18
| Facility | | $16.22 | $18.20 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.51 / $11.48
| Professional | | $8.51 | $8.51 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $26.30 / $69.18
| Facility | | $6.76 | $26.30 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $19.50
| Professional | | $6.76 | $6.76 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $8.32 / $10.23
| Professional | | $6.76 | $8.32 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $14.45 / $19.95
| Professional | | $7.94 | $14.45 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $12.59 / $12.59
| Facility | | $7.08 | $12.59 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.76 / $7.24
| Professional | | $5.75 | $6.76 | $7.24 |