- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $19.95 / $36.31
| Facility | | $5.89 | $19.95 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $7.94
| Professional | | $3.98 | $5.01 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $3.98
| Professional | | $3.98 | $3.98 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $6.61 / $7.76
| Facility | | $5.89 | $6.61 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $6.61 / $8.51
| Professional | | $5.50 | $6.61 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $7.41 / $16.98
| Facility | | $4.68 | $7.41 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $6.76 / $12.88
| Professional | | $3.47 | $6.76 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $24.55 / $53.70
| Facility | | $5.75 | $24.55 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $8.13
| Professional | | $3.98 | $3.98 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.16 / $3.98
| Professional | | $3.16 | $3.16 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $5.50 / $8.13
| Facility | | $2.82 | $5.50 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.55 / $9.33
| Professional | | $2.75 | $3.55 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $6.61
| Professional | | $3.98 | $3.98 | $6.61 |