- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $19.95 / $87.10
| Facility | | $6.31 | $19.95 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $10.00 / $20.42
| Professional | | $6.31 | $10.00 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.24 / $7.41
| Professional | | $6.46 | $7.24 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $12.02 / $14.13
| Facility | | $10.72 | $12.02 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $12.02 / $12.02
| Professional | | $9.55 | $12.02 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.91 / $48.98
| Facility | | $6.03 | $8.91 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $11.48 / $18.62
| Professional | | $5.75 | $11.48 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $14.45
| Professional | | $7.24 | $7.24 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $7.94 / $10.96
| Professional | | $1.45 | $7.94 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $7.24 / $12.02
| Facility | | $4.79 | $7.24 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.01 / $12.59
| Professional | | $4.07 | $5.01 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.91 / $12.02
| Professional | | $8.32 | $8.91 | $12.02 |