- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $16.98 / $61.66
| Facility | | $4.90 | $16.98 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $26.92
| Professional | | $3.02 | $3.98 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $2.95 / $3.39
| Professional | | $2.95 | $2.95 | $3.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $7.24 / $9.77
| Facility | | $5.13 | $7.24 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.37 / $4.90
| Professional | | $3.63 | $4.37 | $4.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $10.72 / $17.38
| Facility | | $5.13 | $10.72 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.25 / $7.59
| Professional | | $3.02 | $5.25 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.27 / $64.57
| Professional | | $3.09 | $4.27 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $4.90 / $10.00
| Facility | | $4.90 | $4.90 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $4.90 / $5.62
| Professional | | $4.90 | $4.90 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $8.51 / $13.49
| Facility | | $4.90 | $8.51 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $5.89
| Professional | | $4.37 | $4.37 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $7.24 / $12.88
| Facility | | $5.62 | $7.24 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.37 / $4.90
| Professional | | $3.63 | $4.37 | $4.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.89 / $5.89
| Facility | | $4.37 | $5.89 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.88 / $6.17
| Professional | | $2.04 | $2.88 | $6.17 |