- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $16.60 / $47.86
| Facility | | $13.49 | $16.60 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $10.00 / $16.60
| Professional | | $6.76 | $10.00 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $28.18 / $30.90
| Facility | | $17.38 | $28.18 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $12.02 / $19.50
| Professional | | $5.62 | $12.02 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $23.44 / $27.54
| Professional | | $21.88 | $23.44 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $15.49
| Facility | | $10.72 | $10.72 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $12.30 / $17.38
| Professional | | $10.72 | $12.30 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $21.38
| Facility | | $10.72 | $10.72 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $10.72 / $21.38
| Professional | | $9.77 | $10.72 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $14.79 / $31.62
| Facility | | $9.77 | $14.79 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $11.75 / $79.43
| Professional | | $9.77 | $11.75 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $32.36 / $44.67
| Facility | | $16.22 | $32.36 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $9.77 / $12.88
| Professional | | $8.13 | $9.77 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $12.88 / $17.38
| Facility | | $5.25 | $12.88 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.68 / $12.88
| Professional | | $4.47 | $4.68 | $12.88 |