- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $12.30 / $51.29
| Facility | | $6.61 | $12.30 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.27 / $7.59
| Professional | | $3.98 | $4.27 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $13.49 / $16.98
| Facility | | $8.32 | $13.49 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $5.89 / $9.33
| Professional | | $3.31 | $5.89 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $11.48 / $12.88
| Professional | | $10.23 | $11.48 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $15.85
| Facility | | $5.13 | $5.13 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.31 / $9.55
| Professional | | $5.13 | $6.31 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $10.00
| Facility | | $5.13 | $5.13 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.13 / $10.00
| Professional | | $5.13 | $5.13 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $7.08 / $15.14
| Facility | | $4.68 | $7.08 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $6.17 / $79.43
| Professional | | $4.79 | $6.17 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $15.14 / $20.89
| Facility | | $7.59 | $15.14 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.79 / $6.17
| Professional | | $3.80 | $4.79 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $6.17 / $8.13
| Facility | | $3.02 | $6.17 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.69 / $6.61
| Professional | | $2.14 | $2.69 | $6.61 |