- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $10.00 / $33.88
| Facility | | $4.68 | $10.00 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $18.20
| Professional | | $3.02 | $3.98 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.25 / $9.12
| Facility | | $4.57 | $5.25 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $3.02 / $6.46
| Professional | | $2.40 | $3.02 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $3.39 / $5.75
| Facility | | $3.39 | $3.39 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $6.76
| Professional | | $6.76 | $6.76 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $6.46 / $20.42
| Facility | | $3.31 | $6.46 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $3.24 / $9.33
| Professional | | $2.45 | $3.24 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $5.75 / $26.92
| Facility | | $3.24 | $5.75 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $3.24 / $9.12
| Professional | | $2.45 | $3.24 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $4.47 / $6.17
| Professional | | $3.72 | $4.47 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $6.03
| Facility | | $6.03 | $6.03 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $5.25 / $10.23
| Professional | | $3.47 | $5.25 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $5.01 / $7.59
| Facility | | $2.09 | $5.01 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $3.02 / $6.03
| Professional | | $2.09 | $3.02 | $6.03 |