- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $12.59 / $97.72
| Facility | | $5.50 | $12.59 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.01 / $8.13
| Professional | | $3.02 | $5.01 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $8.13 / $10.96
| Facility | | $5.75 | $8.13 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.90 / $5.50
| Professional | | $4.17 | $4.90 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $12.30 / $17.78
| Facility | | $5.75 | $12.30 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $5.89 / $8.71
| Professional | | $3.47 | $5.89 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $32.36 / $64.57
| Professional | | $4.27 | $32.36 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $11.22
| Facility | | $5.50 | $5.50 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $11.22
| Professional | | $5.50 | $5.50 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $9.55 / $15.14
| Facility | | $5.50 | $9.55 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $4.90 / $6.61
| Professional | | $4.90 | $4.90 | $6.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $8.32 / $14.45
| Facility | | $6.31 | $8.32 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.90 / $5.50
| Professional | | $4.17 | $4.90 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $6.61 / $6.61
| Facility | | $4.90 | $6.61 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $3.24 / $6.92
| Professional | | $2.29 | $3.24 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $2.82 / $10.00
| Professional | | $2.45 | $2.82 | $10.00 |