- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $11.22 / $14.79
| Facility | | $8.13 | $11.22 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $12.30
| Professional | | $5.01 | $5.01 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.46 / $13.18
| Facility | | $5.75 | $6.46 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.62 / $15.49
| Professional | | $5.37 | $5.62 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $6.17 / $9.77
| Facility | | $5.37 | $6.17 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $7.08 / $15.85
| Professional | | $5.37 | $7.08 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $9.33 / $12.59
| Facility | | $6.46 | $9.33 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $5.50
| Professional | | $5.50 | $5.50 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $6.03 / $12.30
| Professional | | $4.90 | $6.03 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $85.11 / $85.11
| Facility | | $79.43 | $85.11 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $8.91 / $13.80
| Facility | | $5.50 | $8.91 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $6.76
| Professional | | $5.50 | $5.50 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.03 / $9.33
| Professional | | $4.37 | $6.03 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $5.50
| Facility | | $5.50 | $5.50 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.75 / $12.59
| Professional | | $5.37 | $5.75 | $12.59 |