- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $10.00 / $14.45
| Facility | | $5.25 | $10.00 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $10.00
| Professional | | $3.98 | $5.01 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $6.92 / $12.02
| Facility | | $5.89 | $6.92 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.39 / $7.59
| Professional | | $2.57 | $3.39 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $7.41
| Facility | | $4.37 | $4.37 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $8.71
| Professional | | $8.71 | $8.71 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $8.32 / $26.92
| Facility | | $4.27 | $8.32 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $3.55 / $9.77
| Professional | | $2.95 | $3.55 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $22.39
| Facility | | $4.27 | $4.27 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $3.39 / $6.92
| Professional | | $2.95 | $3.39 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $5.89 / $7.94
| Professional | | $4.90 | $5.89 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $7.76
| Facility | | $7.76 | $7.76 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $6.76 / $13.18
| Professional | | $4.57 | $6.76 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $6.46 / $9.77
| Facility | | $3.16 | $6.46 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.89 / $6.92
| Professional | | $2.75 | $3.89 | $6.92 |