- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $25.70 / $58.88
| Facility | | $8.91 | $25.70 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.25 / $8.91
| Professional | | $4.57 | $5.25 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $15.14 / $20.42
| Facility | | $9.33 | $15.14 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.61 / $10.96
| Professional | | $3.98 | $6.61 | $10.96 |
- 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 / $6.92 / $41.69
| Facility | | $5.75 | $6.92 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $7.24 / $11.22
| Professional | | $5.25 | $7.24 | $11.22 |
- 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
- $5.62 / $7.94 / $17.38
| Facility | | $5.62 | $7.94 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.92 / $79.43
| Professional | | $5.75 | $6.92 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $17.38 / $23.44
| Facility | | $8.71 | $17.38 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.89 / $7.41
| Professional | | $4.27 | $5.89 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $6.92 / $9.12
| Facility | | $3.63 | $6.92 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $3.31 / $7.94
| Professional | | $2.40 | $3.31 | $7.94 |