- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $32.36 / $57.54
| Facility | | $11.48 | $32.36 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $6.46 / $10.47
| Professional | | $5.37 | $6.46 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $19.05 / $25.70
| Facility | | $11.75 | $19.05 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $8.13 / $13.49
| Professional | | $5.01 | $8.13 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.85 / $18.62
| Professional | | $15.14 | $15.85 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $11.48 / $53.70
| Facility | | $7.24 | $11.48 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $8.71 / $14.45
| Professional | | $6.46 | $8.71 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $14.45
| Facility | | $7.24 | $7.24 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $13.49
| Professional | | $7.24 | $7.24 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $10.00 / $21.38
| Facility | | $6.46 | $10.00 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $8.91 / $79.43
| Professional | | $7.24 | $8.91 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $21.38 / $29.51
| Facility | | $10.72 | $21.38 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $7.41 / $9.12
| Professional | | $5.37 | $7.41 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $8.71 / $11.48
| Facility | | $4.57 | $8.71 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.07 / $10.00
| Professional | | $3.02 | $4.07 | $10.00 |