- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $20.89 / $2,089.30
| Facility | | $7.94 | $20.89 | $2,089.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.59 / $25.70
| Professional | | $7.08 | $7.59 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $6.76
| Professional | | $6.76 | $6.76 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $12.88 / $36.31
| Facility | | $7.59 | $12.88 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $8.13 / $14.13
| Professional | | $6.92 | $8.13 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $7.94
| Facility | | $7.94 | $7.94 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $10.72
| Professional | | $10.72 | $10.72 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $14.79 / $22.91
| Facility | | $13.18 | $14.79 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $11.75
| Professional | | $6.92 | $6.92 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.00 / $23.99
| Facility | | $7.08 | $10.00 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $45.71
| Professional | | $7.59 | $7.59 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $9.33 / $11.22
| Professional | | $7.59 | $9.33 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $11.75 / $15.14
| Professional | | $6.46 | $11.75 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $19.95
| Facility | | $6.92 | $6.92 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $9.55
| Professional | | $7.59 | $7.59 | $9.55 |