- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $17.38 / $38.02
| Facility | | $5.75 | $17.38 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $10.23
| Professional | | $3.02 | $3.98 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $11.48 / $15.85
| Facility | | $7.08 | $11.48 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $5.01 / $8.32
| Professional | | $2.95 | $5.01 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.00 / $11.22
| Professional | | $8.91 | $10.00 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $19.95
| Facility | | $4.37 | $4.37 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.50 / $8.91
| Professional | | $4.37 | $5.50 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $8.71
| Facility | | $4.37 | $4.37 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.79 / $7.08
| Professional | | $4.37 | $4.79 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $6.31 / $13.18
| Facility | | $4.27 | $6.31 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.25 / $79.43
| Professional | | $4.37 | $5.25 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $13.18 / $18.20
| Facility | | $6.61 | $13.18 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $4.47 / $5.62
| Professional | | $3.31 | $4.47 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $5.25 / $7.08
| Facility | | $2.75 | $5.25 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.51 / $6.17
| Professional | | $1.86 | $2.51 | $6.17 |