- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $45.71 / $169.82
| Facility | | $7.59 | $45.71 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.32 / $32.36
| Professional | | $7.08 | $8.32 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.75 / $6.46
| Professional | | $5.62 | $5.75 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $9.33 / $10.96
| Facility | | $8.13 | $9.33 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $9.33 / $13.49
| Professional | | $7.76 | $9.33 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $11.22 / $23.99
| Facility | | $6.46 | $11.22 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $8.91 / $18.62
| Professional | | $4.90 | $8.91 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $39.81 / $87.10
| Facility | | $9.33 | $39.81 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $12.88
| Professional | | $5.62 | $5.62 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $4.47 / $5.62
| Professional | | $1.12 | $4.47 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $7.59 / $11.48
| Facility | | $3.89 | $7.59 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.50 / $12.88
| Professional | | $3.89 | $5.50 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $9.33
| Professional | | $5.62 | $5.62 | $9.33 |