- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $10.23 / $25.70
| Facility | | $6.03 | $10.23 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $10.00
| Professional | | $5.01 | $6.03 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $24.55 / $33.11
| Facility | | $16.98 | $24.55 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $5.01 / $7.41
| Professional | | $4.68 | $5.01 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $16.22 / $34.67
| Facility | | $5.89 | $16.22 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $6.03 / $12.02
| Professional | | $4.07 | $6.03 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $33.88
| Professional | | $7.41 | $7.41 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $8.32 / $17.38
| Facility | | $4.68 | $8.32 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $12.59 / $14.13
| Professional | | $6.17 | $12.59 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $9.33 / $15.49
| Facility | | $4.68 | $9.33 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $6.17 / $12.30
| Professional | | $3.89 | $6.17 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $112.20
| Facility | | $85.11 | $85.11 | $112.20 |