- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $7.94
| Facility | | $7.08 | $7.08 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $7.08 / $10.96
| Professional | | $4.27 | $7.08 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $14.13 / $14.79
| Facility | | $14.13 | $14.13 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $13.80
| Professional | | $7.24 | $7.24 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.79 / $7.94 / $7.94
| Professional | | $0.79 | $7.94 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $8.32
| Facility | | $8.32 | $8.32 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $7.08
| Professional | | $7.08 | $7.08 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $15.49 / $24.55
| Professional | | $11.48 | $15.49 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $10.00 / $14.79
| Professional | | $10.00 | $10.00 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $10.23 / $17.38
| Facility | | $7.24 | $10.23 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.59 / $9.12
| Professional | | $7.41 | $7.59 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $7.08 / $19.50
| Facility | | $0.95 | $7.08 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.95 / $7.24 / $19.50
| Professional | | $0.95 | $7.24 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.87 / $6.31 / $8.51
| Facility | | $0.87 | $6.31 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $6.92 / $11.48
| Professional | | $5.89 | $6.92 | $11.48 |