- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $23.99 / $47.86
| Facility | | $7.59 | $23.99 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $7.08 / $10.00
| Professional | | $3.98 | $7.08 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $5.37
| Professional | | $5.37 | $5.37 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $8.71 / $10.23
| Facility | | $7.76 | $8.71 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $8.71 / $8.71
| Professional | | $7.24 | $8.71 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $9.12 / $22.39
| Facility | | $5.75 | $9.12 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $8.51 / $16.22
| Professional | | $4.47 | $8.51 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $24.55 / $53.70
| Facility | | $5.75 | $24.55 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $8.91
| Professional | | $5.25 | $5.25 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $4.27 / $5.25
| Professional | | $1.07 | $4.27 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $7.76 / $10.23
| Facility | | $3.72 | $7.76 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.17 / $11.48
| Professional | | $3.09 | $4.17 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $8.71
| Professional | | $5.25 | $5.25 | $8.71 |