- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $21.88 / $48.98
| Facility | | $7.24 | $21.88 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.68 / $8.13
| Professional | | $3.98 | $4.68 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $15.14 / $18.62
| Facility | | $9.33 | $15.14 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $6.61 / $10.47
| Professional | | $3.47 | $6.61 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $12.88 / $14.45
| Professional | | $11.75 | $12.88 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $22.39
| Facility | | $5.75 | $5.75 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.08 / $10.47
| Professional | | $5.75 | $7.08 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $11.48
| Facility | | $5.75 | $5.75 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $6.92
| Professional | | $5.75 | $5.75 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $7.94 / $16.98
| Facility | | $5.25 | $7.94 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $6.76 / $79.43
| Professional | | $5.25 | $6.76 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $17.38 / $23.99
| Facility | | $8.71 | $17.38 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.25 / $6.92
| Professional | | $4.37 | $5.25 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $6.92 / $9.33
| Facility | | $3.24 | $6.92 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $2.95 / $7.24
| Professional | | $2.45 | $2.95 | $7.24 |