- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $44.67 / $81.28
| Facility | | $11.22 | $44.67 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.61 / $24.55
| Professional | | $5.01 | $6.61 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $7.24 / $7.24
| Professional | | $6.17 | $7.24 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $11.22
| Facility | | $8.13 | $8.13 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $12.02 / $12.02
| Professional | | $8.13 | $12.02 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $7.59
| Facility | | $7.59 | $7.59 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $7.24
| Professional | | $4.68 | $4.68 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $9.55 / $19.05
| Facility | | $5.75 | $9.55 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $7.94 / $11.22
| Professional | | $4.27 | $7.94 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.32 / $17.38
| Professional | | $7.08 | $8.32 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $7.24 / $8.32
| Facility | | $4.68 | $7.24 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $4.37 / $12.02
| Professional | | $2.88 | $4.37 | $12.02 |