- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $19.95 / $58.88
| Facility | | $3.47 | $19.95 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.72 / $8.71
| Professional | | $2.00 | $3.72 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.19 / $4.37
| Professional | | $1.86 | $2.19 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $14.13 / $23.44
| Facility | | $5.13 | $14.13 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $2.95 / $5.50
| Professional | | $2.82 | $2.95 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $6.31 / $19.95
| Facility | | $3.09 | $6.31 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $4.37 / $7.41
| Professional | | $2.24 | $4.37 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $4.37
| Facility | | $4.37 | $4.37 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $8.32 / $19.50
| Facility | | $3.80 | $8.32 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.63 / $7.24
| Professional | | $2.19 | $3.63 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $100.00
| Facility | | $60.26 | $60.26 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $7.08
| Professional | | $7.08 | $7.08 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $4.79 / $52.48
| Facility | | $3.16 | $4.79 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $4.07 / $7.59
| Professional | | $2.19 | $4.07 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.72 / $3.72
| Professional | | $3.31 | $3.72 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $4.37 / $12.88
| Facility | | $3.16 | $4.37 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.63 / $7.41
| Professional | | $2.19 | $3.63 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $4.37 / $5.25
| Facility | | $1.82 | $4.37 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $2.69 / $4.37
| Professional | | $2.63 | $2.69 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $3.02 / $4.37
| Professional | | $2.29 | $3.02 | $4.37 |