- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $18.62 / $52.48
| Facility | | $3.89 | $18.62 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.51 / $11.48
| Professional | | $7.08 | $8.51 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.89 / $6.46
| Professional | | $5.75 | $5.89 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $9.77 / $11.48
| Facility | | $8.51 | $9.77 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $9.77 / $14.13
| Professional | | $8.13 | $9.77 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $11.75 / $25.12
| Facility | | $6.76 | $11.75 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $9.77 / $19.50
| Professional | | $5.13 | $9.77 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $41.69 / $91.20
| Facility | | $9.55 | $41.69 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $13.49
| Professional | | $5.75 | $5.75 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.15 / $4.68 / $5.75
| Professional | | $1.15 | $4.68 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $7.94 / $12.02
| Facility | | $4.07 | $7.94 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.75 / $13.49
| Professional | | $4.07 | $5.75 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $9.77
| Professional | | $5.75 | $5.75 | $9.77 |