- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $23.44 / $42.66
| Facility | | $7.08 | $23.44 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $10.00
| Professional | | $5.01 | $6.03 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $4.68
| Professional | | $4.68 | $4.68 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $7.94 / $9.33
| Facility | | $6.92 | $7.94 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.94 / $10.47
| Professional | | $6.46 | $7.94 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $8.71 / $20.42
| Facility | | $5.50 | $8.71 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.13 / $15.49
| Professional | | $4.07 | $8.13 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $29.51 / $64.57
| Facility | | $7.08 | $29.51 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $10.00
| Professional | | $4.68 | $4.68 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $4.68
| Professional | | $3.80 | $3.80 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $6.46 / $9.77
| Facility | | $3.31 | $6.46 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $4.37 / $10.96
| Professional | | $3.31 | $4.37 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $7.94
| Professional | | $4.68 | $4.68 | $7.94 |