- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $19.05 / $95.50
| Facility | | $8.91 | $19.05 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.32 / $25.70
| Professional | | $7.08 | $8.32 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $6.61 / $14.79
| Professional | | $5.62 | $6.61 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $10.00 / $17.38
| Facility | | $8.71 | $10.00 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $5.89 / $12.02
| Professional | | $4.68 | $5.89 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $6.46
| Facility | | $6.46 | $6.46 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $7.59
| Professional | | $7.59 | $7.59 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $10.96
| Facility | | $6.46 | $6.46 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $12.88 / $12.88
| Professional | | $12.88 | $12.88 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $12.30 / $38.90
| Facility | | $6.17 | $12.30 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $6.17 / $17.78
| Professional | | $4.79 | $6.17 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $16.98 / $93.33
| Facility | | $6.17 | $16.98 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $6.31 / $15.85
| Professional | | $4.79 | $6.31 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.51 / $11.75
| Professional | | $7.08 | $8.51 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $11.22
| Facility | | $11.22 | $11.22 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $10.00 / $19.50
| Professional | | $6.61 | $10.00 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $9.55 / $14.13
| Facility | | $3.98 | $9.55 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.62 / $11.22
| Professional | | $3.98 | $5.62 | $11.22 |