- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $34.67 / $63.10
| Facility | | $7.76 | $34.67 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $6.03 / $14.45
| Professional | | $3.80 | $6.03 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $5.75 / $5.75
| Professional | | $2.63 | $5.75 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $6.61 / $9.12
| Facility | | $6.61 | $6.61 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $8.71 / $8.71
| Professional | | $5.89 | $8.71 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $6.17
| Facility | | $6.17 | $6.17 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $5.75
| Professional | | $3.80 | $3.80 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.89 / $11.22
| Facility | | $3.89 | $5.89 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.27 / $8.32
| Professional | | $2.69 | $4.27 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.76 / $10.23
| Professional | | $5.75 | $6.76 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $5.25 / $6.92
| Facility | | $3.80 | $5.25 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $5.50 / $7.24
| Professional | | $3.47 | $5.50 | $7.24 |