- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $11.75 / $34.67
| Facility | | $9.55 | $11.75 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.08 / $11.75
| Professional | | $5.01 | $7.08 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $19.95 / $26.30
| Facility | | $12.30 | $19.95 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $8.51 / $14.13
| Professional | | $5.13 | $8.51 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $16.98 / $19.50
| Professional | | $15.85 | $16.98 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $11.22
| Facility | | $7.59 | $7.59 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $10.00 / $14.79
| Professional | | $7.59 | $10.00 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $15.49
| Facility | | $7.59 | $7.59 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $15.49
| Professional | | $7.59 | $7.59 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $10.96 / $22.39
| Facility | | $7.41 | $10.96 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.12 / $79.43
| Professional | | $7.41 | $9.12 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $22.91 / $31.62
| Facility | | $11.48 | $22.91 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.59 / $9.33
| Professional | | $5.75 | $7.59 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $9.12 / $12.30
| Facility | | $4.68 | $9.12 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.27 / $10.23
| Professional | | $3.24 | $4.27 | $10.23 |