- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $15.85 / $27.54
| Facility | | $6.76 | $15.85 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $20.42
| Professional | | $3.02 | $3.98 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.12 / $33.11 / $5,011.87
| Facility | | $25.12 | $33.11 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.47 / $4.68
| Professional | | $4.47 | $4.47 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $8.32 / $19.95
| Facility | | $4.17 | $8.32 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $6.61 / $11.22
| Professional | | $2.75 | $6.61 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.79 / $8.32
| Professional | | $2.69 | $4.79 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $5.75
| Facility | | $5.75 | $5.75 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.75 / $10.00
| Professional | | $5.01 | $5.75 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $19.50 / $35.48
| Facility | | $13.18 | $19.50 | $35.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $12.59 / $19.95
| Facility | | $4.68 | $12.59 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $6.03
| Professional | | $3.02 | $3.98 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.01 / $5.75
| Facility | | $4.17 | $5.01 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $6.61
| Professional | | $3.98 | $5.01 | $6.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $5.75 / $6.92
| Facility | | $2.88 | $5.75 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $4.90 / $8.32
| Professional | | $3.16 | $4.90 | $8.32 |