- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $18.62 / $57.54
| Facility | | $10.00 | $18.62 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.91 / $14.79
| Professional | | $6.03 | $8.91 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $14.79 / $19.95
| Facility | | $10.00 | $14.79 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $8.91 / $10.00
| Professional | | $7.41 | $8.91 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $21.88 / $27.54
| Facility | | $9.77 | $21.88 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $10.47 / $14.45
| Professional | | $5.13 | $10.47 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $8.71 / $64.57
| Professional | | $6.31 | $8.71 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $19.95
| Facility | | $10.00 | $10.00 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $10.96
| Professional | | $10.00 | $10.00 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $15.85 / $27.54
| Facility | | $10.00 | $15.85 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $12.02
| Professional | | $8.91 | $8.91 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $14.79 / $26.30
| Facility | | $11.48 | $14.79 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $8.91 / $10.00
| Professional | | $7.41 | $8.91 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.02 / $12.02
| Facility | | $8.91 | $12.02 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.47 / $11.22
| Professional | | $4.17 | $4.47 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $5.13 / $17.78
| Professional | | $4.47 | $5.13 | $17.78 |