- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $30.20 / $83.18
| Facility | | $13.18 | $30.20 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $12.88 / $32.36
| Professional | | $10.00 | $12.88 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $14.79 / $25.70
| Facility | | $12.59 | $14.79 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $8.71 / $18.20
| Professional | | $6.92 | $8.71 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $9.55 / $15.85
| Facility | | $9.55 | $9.55 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.62 / $18.62 / $18.62
| Professional | | $18.62 | $18.62 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $18.20 / $57.54
| Facility | | $9.12 | $18.20 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $9.12 / $26.92
| Professional | | $7.08 | $9.12 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.33 / $52.48
| Facility | | $9.12 | $9.33 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $9.12 / $26.30
| Professional | | $7.08 | $9.12 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $12.59 / $16.98
| Professional | | $10.47 | $12.59 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $16.60
| Facility | | $16.60 | $16.60 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $14.45 / $28.18
| Professional | | $9.77 | $14.45 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $13.80 / $20.89
| Facility | | $6.31 | $13.80 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $8.32 / $16.60
| Professional | | $5.89 | $8.32 | $16.60 |