- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $15.49 / $60.26
| Facility | | $5.50 | $15.49 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.89 / $6.31
| Professional | | $3.02 | $3.89 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $11.22 / $15.14
| Facility | | $6.92 | $11.22 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $4.79 / $7.94
| Professional | | $2.95 | $4.79 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $9.33 / $10.96
| Professional | | $8.91 | $9.33 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $16.98
| Facility | | $4.27 | $4.27 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.13 / $7.24
| Professional | | $4.27 | $5.13 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $8.51
| Facility | | $4.27 | $4.27 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $6.31
| Professional | | $4.27 | $4.27 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $6.17 / $13.18
| Facility | | $4.17 | $6.17 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.13 / $79.43
| Professional | | $4.27 | $5.13 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $12.88 / $17.78
| Facility | | $6.46 | $12.88 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.37 / $5.50
| Professional | | $3.24 | $4.37 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $5.13 / $6.76
| Facility | | $2.69 | $5.13 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.47 / $6.03
| Professional | | $2.57 | $3.47 | $6.03 |