- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $18.62 / $91.20
| Facility | | $9.33 | $18.62 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $17.38
| Professional | | $7.08 | $8.91 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $11.48 / $20.42
| Facility | | $10.00 | $11.48 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.75 / $14.13
| Professional | | $4.37 | $5.75 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $12.59
| Facility | | $7.41 | $7.41 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $14.79 / $14.79
| Professional | | $14.79 | $14.79 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $14.13 / $45.71
| Facility | | $7.24 | $14.13 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $5.89 / $16.60
| Professional | | $4.90 | $5.89 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $19.05 / $56.23
| Facility | | $7.08 | $19.05 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $5.62 / $11.75
| Professional | | $4.90 | $5.62 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.23 / $13.49
| Professional | | $8.32 | $10.23 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $13.18
| Facility | | $13.18 | $13.18 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $11.48 / $22.39
| Professional | | $7.76 | $11.48 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $10.96 / $16.60
| Facility | | $5.25 | $10.96 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $6.61 / $11.75
| Professional | | $4.57 | $6.61 | $11.75 |