- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $7.59 / $10.00
| Facility | | $3.02 | $7.59 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $3.98
| Professional | | $3.02 | $3.02 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $6.61 / $11.22
| Facility | | $3.24 | $6.61 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.24 / $5.50
| Professional | | $3.24 | $3.24 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $8.51 / $12.88
| Professional | | $7.41 | $8.51 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $6.17 / $8.13
| Facility | | $4.57 | $6.17 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.24 / $3.24
| Professional | | $3.24 | $3.24 | $3.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.63 / $21.88
| Professional | | $2.75 | $3.63 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $3.63 / $5.75
| Facility | | $3.63 | $3.63 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.79 / $17.78
| Facility | | $3.09 | $4.79 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.79 / $17.78
| Professional | | $3.09 | $4.79 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $6.76 / $14.79
| Facility | | $3.24 | $6.76 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.63 / $7.08
| Professional | | $3.47 | $3.63 | $7.08 |