- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $11.75 / $19.50
| Facility | | $6.17 | $11.75 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $11.75
| Professional | | $6.03 | $7.08 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.13 / $14.13
| Facility | | $7.08 | $8.13 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.79 / $10.00
| Professional | | $3.80 | $4.79 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.47 / $8.91
| Facility | | $4.47 | $4.47 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $10.47 / $10.47
| Professional | | $10.47 | $10.47 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $10.00 / $31.62
| Facility | | $5.13 | $10.00 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.89 / $14.79
| Professional | | $3.98 | $5.89 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.13 / $29.51
| Facility | | $5.01 | $5.13 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.62 / $12.30
| Professional | | $3.98 | $5.62 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.24 / $9.55
| Professional | | $5.75 | $7.24 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.33 / $9.33
| Facility | | $9.33 | $9.33 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $8.13 / $15.85
| Professional | | $5.37 | $8.13 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $7.76 / $11.48
| Facility | | $3.89 | $7.76 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.68 / $10.47
| Professional | | $3.24 | $4.68 | $10.47 |