- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $10.00 / $33.88
| Facility | | $5.25 | $10.00 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.27 / $7.94
| Professional | | $3.02 | $4.27 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $11.75 / $15.49
| Facility | | $8.71 | $11.75 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $5.75 / $9.33
| Professional | | $2.14 | $5.75 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $11.48 / $13.49
| Professional | | $10.96 | $11.48 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $9.33
| Facility | | $5.37 | $5.37 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $5.37 / $7.59
| Professional | | $4.47 | $5.37 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $10.47
| Facility | | $5.37 | $5.37 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $9.77
| Professional | | $5.37 | $5.37 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $7.41 / $15.85
| Facility | | $4.79 | $7.41 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $5.89 / $79.43
| Professional | | $4.47 | $5.89 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $15.85 / $21.88
| Facility | | $7.94 | $15.85 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $4.17 / $6.31
| Professional | | $3.31 | $4.17 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $6.31 / $8.51
| Facility | | $2.04 | $6.31 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.16 / $5.37
| Professional | | $2.63 | $3.16 | $5.37 |