- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $15.49 / $77.62
| Facility | | $6.61 | $15.49 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $13.18 / $46.77
| Professional | | $6.03 | $13.18 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $14.45 / $20.89
| Professional | | $12.59 | $14.45 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $19.50
| Facility | | $13.18 | $13.18 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $38.90 / $61.66
| Facility | | $20.89 | $38.90 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $15.49 / $17.78
| Professional | | $12.88 | $15.49 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $9.55 / $24.55
| Facility | | $6.31 | $9.55 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $38.90 / $52.48
| Professional | | $13.49 | $38.90 | $52.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $13.80 / $89.13
| Facility | | $6.31 | $13.80 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $9.55 / $21.88
| Professional | | $7.24 | $9.55 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $54.95 / $70.79
| Professional | | $16.22 | $54.95 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.50 / $19.50 / $19.50
| Professional | | $19.50 | $19.50 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $29.51 / $40.74
| Professional | | $16.22 | $29.51 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $23.44 / $89.13
| Facility | | $20.89 | $23.44 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $20.89 / $89.13
| Professional | | $15.49 | $20.89 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $32.36 / $36.31
| Professional | | $32.36 | $32.36 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $9.33 / $10.23
| Facility | | $6.31 | $9.33 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $25.70 / $95.50
| Professional | | $7.24 | $25.70 | $95.50 |