- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $30.20 / $104.71
| Facility | | $8.91 | $30.20 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $51.29
| Professional | | $6.03 | $7.08 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $4.90 / $4.90
| Professional | | $4.90 | $4.90 | $4.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $8.71 / $15.14
| Facility | | $7.41 | $8.71 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.68 / $6.76
| Professional | | $3.63 | $4.68 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $8.51 / $10.23
| Facility | | $5.50 | $8.51 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $8.13 / $10.96
| Professional | | $5.37 | $8.13 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $10.72 / $33.11
| Facility | | $5.37 | $10.72 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.62 / $15.49
| Professional | | $4.17 | $5.62 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $34.67 / $112.20
| Facility | | $8.32 | $34.67 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.50 / $12.88
| Professional | | $4.17 | $5.50 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $7.41 / $10.00
| Professional | | $6.17 | $7.41 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $9.77
| Facility | | $9.77 | $9.77 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $8.51 / $16.60
| Professional | | $5.75 | $8.51 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $8.13 / $12.30
| Facility | | $3.47 | $8.13 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.61 / $11.22
| Professional | | $4.47 | $6.61 | $11.22 |