- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $20.89 / $93.33
| Facility | | $10.47 | $20.89 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.02 / $17.38
| Professional | | $8.91 | $12.02 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $9.12 / $34.67
| Professional | | $7.94 | $9.12 | $34.67 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $29.51 / $57.54 / $57.54
| Facility | | $29.51 | $57.54 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $9.33 / $12.02
| Professional | | $6.03 | $9.33 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $27.54 / $60.26
| Facility | | $9.12 | $27.54 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $9.12 / $20.42
| Professional | | $6.92 | $9.12 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $25.70 / $37.15
| Professional | | $10.96 | $25.70 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $12.02 / $25.70
| Facility | | $10.72 | $12.02 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $14.79 / $16.22
| Professional | | $10.72 | $14.79 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $13.18 / $22.91
| Facility | | $6.92 | $13.18 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $9.33 / $18.62
| Professional | | $6.61 | $9.33 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $67.61 / $67.61
| Facility | | $67.61 | $67.61 | $67.61 |