- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $20.42
| Facility | | $7.94 | $7.94 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $7.94 / $12.02
| Professional | | $3.98 | $7.94 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $13.18
| Facility | | $13.18 | $13.18 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $16.22
| Professional | | $13.18 | $13.18 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $9.12 / $9.12
| Facility | | $7.94 | $9.12 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $9.12
| Professional | | $7.76 | $7.76 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $20.42 / $33.11
| Facility | | $14.45 | $20.42 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $20.89 / $33.11
| Professional | | $14.45 | $20.89 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $11.48 / $60.26
| Professional | | $10.47 | $11.48 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $14.13 / $14.45
| Facility | | $11.48 | $14.13 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $13.49 / $14.45
| Professional | | $11.48 | $13.49 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $13.18 / $24.55
| Facility | | $12.59 | $13.18 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $12.59 / $14.79
| Professional | | $12.59 | $12.59 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $12.30 / $13.18 / $16.22
| Professional | | $12.30 | $13.18 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $6.46 / $8.71
| Facility | | $5.37 | $6.46 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.92 / $12.30
| Professional | | $6.03 | $6.92 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $13.18 / $22.91
| Professional | | $8.91 | $13.18 | $22.91 |