- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $25.70 / $67.61
| Facility | | $7.59 | $25.70 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.25 / $9.12
| Professional | | $3.98 | $5.25 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $15.49 / $20.89
| Facility | | $9.55 | $15.49 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.61 / $10.96
| Professional | | $3.98 | $6.61 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $12.88 / $15.14
| Professional | | $12.30 | $12.88 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $5.89 / $26.92
| Facility | | $5.89 | $5.89 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $7.41 / $11.75
| Professional | | $5.89 | $7.41 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $5.89 / $12.02
| Facility | | $5.89 | $5.89 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $6.46 / $9.33
| Professional | | $5.89 | $6.46 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $8.13 / $17.38
| Facility | | $5.75 | $8.13 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $7.08 / $79.43
| Professional | | $5.89 | $7.08 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $17.78 / $24.55
| Facility | | $8.91 | $17.78 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.03 / $7.59
| Professional | | $4.37 | $6.03 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $7.08 / $9.33
| Facility | | $3.72 | $7.08 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $3.39 / $8.13
| Professional | | $2.45 | $3.39 | $8.13 |