- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $10.00 / $29.51
| Facility | | $8.13 | $10.00 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.03 / $10.00
| Professional | | $3.98 | $6.03 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $16.98 / $19.05
| Facility | | $10.47 | $16.98 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $7.24 / $11.75
| Professional | | $3.47 | $7.24 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $14.13 / $16.22
| Professional | | $12.88 | $14.13 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $9.33
| Facility | | $6.46 | $6.46 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.41 / $10.47
| Professional | | $6.46 | $7.41 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $12.59
| Facility | | $6.46 | $6.46 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $7.76
| Professional | | $6.46 | $6.46 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $9.12 / $19.05
| Facility | | $5.25 | $9.12 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $7.08 / $79.43
| Professional | | $5.89 | $7.08 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $19.50 / $26.92
| Facility | | $9.77 | $19.50 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $5.89 / $7.76
| Professional | | $4.90 | $5.89 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $7.76 / $10.47
| Facility | | $3.09 | $7.76 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $2.82 / $7.76
| Professional | | $2.75 | $2.82 | $7.76 |