- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $34.67 / $87.10
| Facility | | $12.59 | $34.67 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $11.75 / $36.31
| Professional | | $10.00 | $11.75 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $9.12 / $9.12
| Professional | | $6.61 | $9.12 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $13.80 / $24.55
| Facility | | $12.02 | $13.80 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $8.13 / $16.98
| Professional | | $6.46 | $8.13 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $8.91 / $8.91
| Facility | | $8.91 | $8.91 | $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
- $13.18 / $13.80 / $16.60
| Facility | | $13.18 | $13.80 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $13.18 / $17.78
| Professional | | $8.51 | $13.18 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $16.98 / $54.95
| Facility | | $8.91 | $16.98 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $8.71 / $25.12
| Professional | | $6.76 | $8.71 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $19.05 / $54.95
| Facility | | $8.51 | $19.05 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $13.18 / $38.02
| Professional | | $6.92 | $13.18 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $11.75 / $16.22
| Professional | | $10.00 | $11.75 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $15.85 / $15.85
| Facility | | $15.85 | $15.85 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $14.45 / $28.84
| Professional | | $9.33 | $14.45 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $13.18 / $19.95
| Facility | | $5.50 | $13.18 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $7.94 / $15.85
| Professional | | $5.50 | $7.94 | $15.85 |