- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $18.20 / $30.90
| Facility | | $10.00 | $18.20 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $19.05
| Professional | | $7.94 | $10.00 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $13.18 / $22.91
| Facility | | $11.48 | $13.18 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $7.24 / $15.85
| Professional | | $5.62 | $7.24 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $14.45
| Facility | | $8.32 | $8.32 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $16.60
| Professional | | $16.60 | $16.60 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $16.22 / $51.29
| Facility | | $8.13 | $16.22 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.76 / $21.88
| Professional | | $5.75 | $7.76 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $42.66
| Facility | | $8.13 | $8.13 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.41 / $15.85
| Professional | | $5.75 | $7.41 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $11.75 / $15.49
| Professional | | $9.33 | $11.75 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $14.79 / $14.79
| Facility | | $14.79 | $14.79 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $13.18 / $25.12
| Professional | | $8.71 | $13.18 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $12.30 / $18.62
| Facility | | $5.25 | $12.30 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $7.41 / $14.79
| Professional | | $5.25 | $7.41 | $14.79 |