- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $22.39 / $22.39
| Facility | | $8.91 | $22.39 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $8.91
| Professional | | $5.01 | $6.03 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $13.18 / $27.54
| Professional | | $8.32 | $13.18 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $6.17
| Facility | | $6.17 | $6.17 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $26.30 / $41.69
| Facility | | $22.39 | $26.30 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $14.13 / $25.12
| Professional | | $9.55 | $14.13 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $28.18 / $46.77
| Facility | | $4.17 | $28.18 | $46.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $7.24 / $60.26
| Facility | | $4.17 | $7.24 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.79 / $14.45
| Professional | | $4.07 | $4.79 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $12.02 / $85.11
| Professional | | $8.13 | $12.02 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $9.77 / $22.91
| Facility | | $8.71 | $9.77 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.13 / $16.22
| Professional | | $6.03 | $8.13 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $18.62 / $26.30
| Professional | | $10.72 | $18.62 | $26.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $16.22 / $70.79
| Facility | | $16.22 | $16.22 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $17.38
| Professional | | $17.38 | $17.38 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $43.65 / $43.65 / $43.65
| Professional | | $43.65 | $43.65 | $43.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $6.46 / $9.77
| Facility | | $4.07 | $6.46 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $4.79 / $14.45
| Professional | | $3.39 | $4.79 | $14.45 |