- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $23.99 / $87.10
| Facility | | $4.37 | $23.99 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $4.47 / $15.85
| Professional | | $2.88 | $4.47 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $9.12 / $10.00
| Facility | | $5.62 | $9.12 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $3.89 / $6.46
| Professional | | $1.78 | $3.89 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $7.76 / $8.51
| Professional | | $6.76 | $7.76 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.79 / $85.11
| Facility | | $3.47 | $4.79 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.17 / $8.13
| Professional | | $3.09 | $4.17 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $6.76
| Facility | | $3.47 | $3.47 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $3.98
| Professional | | $3.47 | $3.47 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $4.79 / $10.23
| Facility | | $3.16 | $4.79 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.89 / $79.43
| Professional | | $3.16 | $3.89 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $10.47 / $14.45
| Facility | | $5.25 | $10.47 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.16 / $4.17
| Professional | | $2.63 | $3.16 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $4.17 / $5.62
| Facility | | $1.62 | $4.17 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.09 / $4.17
| Professional | | $2.09 | $2.09 | $4.17 |