- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $10.00 / $10.96
| Facility | | $7.94 | $10.00 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $10.00 / $12.88
| Professional | | $6.61 | $10.00 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $16.60 / $43.65
| Facility | | $12.59 | $16.60 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $8.51
| Professional | | $7.59 | $7.59 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $12.88 / $17.78
| Professional | | $9.77 | $12.88 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $79.43
| Facility | | $16.22 | $16.22 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $9.55 / $9.55
| Facility | | $8.13 | $9.55 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $9.55
| Professional | | $8.13 | $8.13 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $85.11 / $85.11
| Facility | | $79.43 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $117.49 / $117.49
| Professional | | $79.43 | $117.49 | $117.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $13.49 / $22.39
| Facility | | $7.94 | $13.49 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.00 / $15.14
| Professional | | $7.08 | $10.00 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $81.28
| Professional | | $10.72 | $10.72 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $12.88 / $22.39
| Facility | | $7.94 | $12.88 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $9.55
| Professional | | $8.13 | $8.13 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.31 / $9.55
| Facility | | $5.01 | $6.31 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $7.24 / $9.55
| Professional | | $5.62 | $7.24 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $16.22 / $16.22
| Professional | | $7.94 | $16.22 | $16.22 |