- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $33.88 / $60.26
| Facility | | $10.00 | $33.88 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $8.91 / $12.88
| Professional | | $7.94 | $8.91 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $6.92
| Professional | | $6.76 | $6.76 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $11.22 / $13.18
| Facility | | $10.00 | $11.22 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $11.22 / $15.85
| Professional | | $9.33 | $11.22 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $13.80 / $28.84
| Facility | | $7.94 | $13.80 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $9.55 / $22.91
| Professional | | $6.03 | $9.55 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $52.48 / $107.15
| Facility | | $11.75 | $52.48 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $15.85
| Professional | | $6.76 | $6.76 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $5.37 / $7.24
| Professional | | $1.35 | $5.37 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $9.12 / $13.80
| Facility | | $4.68 | $9.12 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.61 / $15.85
| Professional | | $4.68 | $6.61 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $11.22
| Professional | | $7.24 | $7.24 | $11.22 |