- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $32.36 / $91.20
| Facility | | $8.91 | $32.36 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $8.91 / $23.99
| Professional | | $3.63 | $8.91 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.14 / $10.00
| Professional | | $2.14 | $2.14 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $18.62
| Professional | | $16.60 | $16.60 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.17 / $6.76
| Facility | | $3.63 | $4.17 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $7.76 / $8.91
| Professional | | $1.51 | $7.76 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $10.47 / $19.95
| Facility | | $3.89 | $10.47 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $9.33 / $23.99
| Professional | | $7.76 | $9.33 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $18.62 / $45.71
| Facility | | $5.25 | $18.62 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $3.02 / $9.77
| Professional | | $1.62 | $3.02 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $50.12 / $70.79
| Professional | | $32.36 | $50.12 | $70.79 |
- 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
- $6.92 / $10.23 / $15.14
| Professional | | $6.92 | $10.23 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $24.55 / $1,288.25
| Facility | | $24.55 | $24.55 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $38.90 / $66.07
| Professional | | $8.71 | $38.90 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $23.44 / $23.44
| Professional | | $13.49 | $23.44 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $2.29 / $6.31
| Facility | | $2.29 | $2.29 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $3.02 / $8.91
| Professional | | $1.62 | $3.02 | $8.91 |