- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $19.50 / $28.18
| Facility | | $10.23 | $19.50 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.00 / $19.50
| Professional | | $8.91 | $10.00 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $13.49 / $23.44
| Facility | | $11.75 | $13.49 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $7.24 / $15.14
| Professional | | $5.25 | $7.24 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.51 / $14.45
| Facility | | $8.51 | $8.51 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $16.98 / $16.98
| Professional | | $16.98 | $16.98 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $16.60 / $51.29
| Facility | | $8.32 | $16.60 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $8.32 / $19.50
| Professional | | $5.75 | $8.32 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $43.65
| Facility | | $8.32 | $8.32 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $8.32 / $13.80
| Professional | | $5.75 | $8.32 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $10.47 / $15.85
| Professional | | $6.92 | $10.47 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $15.14
| Facility | | $15.14 | $15.14 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $13.49 / $25.70
| Professional | | $8.91 | $13.49 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $12.59 / $19.05
| Facility | | $5.37 | $12.59 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $8.91 / $14.45
| Professional | | $6.46 | $8.91 | $14.45 |