- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $17.78 / $31.62
| Facility | | $7.24 | $17.78 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.94 / $31.62
| Professional | | $6.03 | $7.94 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $9.12 / $15.85
| Facility | | $7.94 | $9.12 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.37 / $11.75
| Professional | | $4.27 | $5.37 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $10.00
| Facility | | $6.03 | $6.03 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $11.75 / $11.75
| Professional | | $11.75 | $11.75 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $11.22 / $35.48
| Facility | | $5.62 | $11.22 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $7.41 / $16.60
| Professional | | $4.47 | $7.41 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $11.22 / $93.33
| Facility | | $5.62 | $11.22 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $8.71 / $13.80
| Professional | | $4.47 | $8.71 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $4.79 / $4.79
| Professional | | $4.79 | $4.79 | $4.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $10.23
| Facility | | $10.23 | $10.23 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $9.12 / $17.38
| Professional | | $6.03 | $9.12 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $8.71 / $12.88
| Facility | | $3.63 | $8.71 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $7.08 / $11.75
| Professional | | $5.13 | $7.08 | $11.75 |