- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $19.05 / $58.88
| Facility | | $10.00 | $19.05 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $15.14
| Professional | | $7.08 | $8.91 | $15.14 |
- 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
- $7.59 / $9.12 / $10.00
| Professional | | $7.59 | $9.12 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $22.39 / $27.54
| Facility | | $10.00 | $22.39 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $10.72 / $14.45
| Professional | | $5.13 | $10.72 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $8.91 / $64.57
| Professional | | $6.46 | $8.91 | $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 / $19.05
| Professional | | $10.00 | $10.00 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $16.22 / $27.54
| Facility | | $10.00 | $16.22 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $12.02
| Professional | | $9.12 | $9.12 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $15.14 / $26.92
| Facility | | $11.48 | $15.14 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $9.12 / $10.00
| Professional | | $7.59 | $9.12 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $12.02 / $12.02
| Facility | | $9.12 | $12.02 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.47 / $11.22
| Professional | | $4.27 | $4.47 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.25 / $18.20
| Professional | | $4.57 | $5.25 | $18.20 |