- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $23.99 / $66.07
| Facility | | $5.50 | $23.99 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.13 / $8.13
| Professional | | $4.27 | $5.13 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $3.98
| Professional | | $3.98 | $3.98 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.51 / $11.48
| Facility | | $6.03 | $8.51 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.13 / $5.75
| Professional | | $4.27 | $5.13 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $12.59 / $19.50
| Facility | | $6.03 | $12.59 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $6.17 / $9.12
| Professional | | $3.63 | $6.17 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $5.01 / $6.03
| Professional | | $3.63 | $5.01 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $11.48
| Facility | | $5.75 | $5.75 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $10.00 / $15.85
| Facility | | $5.75 | $10.00 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $6.92
| Professional | | $5.13 | $5.13 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $8.71 / $15.14
| Facility | | $6.61 | $8.71 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.13 / $5.75
| Professional | | $4.27 | $5.13 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.92 / $6.92
| Facility | | $5.13 | $6.92 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $3.39 / $7.24
| Professional | | $2.40 | $3.39 | $7.24 |