- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $25.70 / $51.29
| Facility | | $7.76 | $25.70 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $11.75
| Professional | | $6.03 | $7.08 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $5.50
| Professional | | $5.50 | $5.50 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $9.12 / $10.72
| Facility | | $7.94 | $9.12 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $9.12 / $12.30
| Professional | | $7.59 | $9.12 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $10.23 / $23.44
| Facility | | $6.03 | $10.23 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $8.71 / $16.98
| Professional | | $4.68 | $8.71 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $36.31 / $79.43
| Facility | | $8.32 | $36.31 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $11.75
| Professional | | $5.50 | $5.50 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.10 / $4.37 / $5.50
| Professional | | $1.10 | $4.37 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $6.92 / $10.47
| Facility | | $3.80 | $6.92 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $5.01 / $15.85
| Professional | | $3.80 | $5.01 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $9.12
| Professional | | $5.50 | $5.50 | $9.12 |