- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $19.50 / $63.10
| Facility | | $5.62 | $19.50 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.00 / $20.42
| Professional | | $7.08 | $10.00 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.92 / $7.08
| Professional | | $6.17 | $6.92 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $11.48 / $13.49
| Facility | | $10.23 | $11.48 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $11.48 / $11.48
| Professional | | $9.12 | $11.48 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $10.23 / $46.77
| Facility | | $6.17 | $10.23 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $11.22 / $17.38
| Professional | | $5.37 | $11.22 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $14.45
| Professional | | $6.92 | $6.92 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $7.76 / $10.47
| Professional | | $1.95 | $7.76 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $6.92 / $11.48
| Facility | | $4.79 | $6.92 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.79 / $12.59
| Professional | | $4.07 | $4.79 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.47 / $11.48
| Professional | | $7.94 | $10.47 | $11.48 |