- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $14.45 / $25.12
| Facility | | $6.76 | $14.45 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.08 / $12.88
| Professional | | $5.01 | $7.08 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $8.91 / $15.49
| Facility | | $7.76 | $8.91 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.13 / $10.96
| Professional | | $4.17 | $5.13 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $9.77
| Facility | | $5.75 | $5.75 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $11.22
| Professional | | $11.22 | $11.22 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $10.96 / $34.67
| Facility | | $5.50 | $10.96 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.50 / $16.22
| Professional | | $4.27 | $5.50 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.62 / $32.36
| Facility | | $5.50 | $5.62 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.50 / $11.75
| Professional | | $4.27 | $5.50 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $7.94 / $10.47
| Professional | | $6.31 | $7.94 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $10.00
| Facility | | $10.00 | $10.00 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $8.91 / $16.98
| Professional | | $5.89 | $8.91 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $8.32 / $12.59
| Facility | | $4.17 | $8.32 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $5.01 / $10.00
| Professional | | $3.55 | $5.01 | $10.00 |