- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.94 / $23.44
| Facility | | $6.46 | $7.94 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $5.01 / $7.94
| Professional | | $3.24 | $5.01 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $13.49 / $24.55
| Facility | | $8.32 | $13.49 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.89 / $10.23
| Professional | | $4.79 | $5.89 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $11.48 / $12.88
| Professional | | $10.23 | $11.48 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $10.47
| Facility | | $5.13 | $5.13 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.92 / $11.75
| Professional | | $5.13 | $6.92 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $10.47
| Facility | | $5.13 | $5.13 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $7.24
| Professional | | $5.13 | $5.13 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.41 / $20.89
| Facility | | $5.01 | $7.41 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.17 / $79.43
| Professional | | $5.13 | $6.17 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $15.49 / $21.38
| Facility | | $7.76 | $15.49 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.62 / $8.71
| Professional | | $3.89 | $5.62 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.17 / $8.32
| Facility | | $4.37 | $6.17 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.80 / $7.59
| Professional | | $2.19 | $3.80 | $7.59 |