- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $21.38 / $104.71
| Facility | | $7.08 | $21.38 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $25.70
| Professional | | $5.01 | $6.03 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $4.90 / $4.90
| Professional | | $3.55 | $4.90 | $4.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.41 / $12.88
| Facility | | $6.46 | $7.41 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.95 / $4.79
| Professional | | $2.14 | $2.95 | $4.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $4.79 / $4.79
| Facility | | $4.79 | $4.79 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $5.62
| Professional | | $5.62 | $5.62 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $7.41 / $8.71
| Facility | | $4.37 | $7.41 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $7.08 / $9.55
| Professional | | $4.57 | $7.08 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $8.51 / $28.84
| Facility | | $4.57 | $8.51 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.79 / $13.49
| Professional | | $3.63 | $4.79 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $36.31 / $97.72
| Facility | | $4.90 | $36.31 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $4.79 / $11.75
| Professional | | $3.39 | $4.79 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $6.31 / $8.71
| Professional | | $5.25 | $6.31 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $8.32 / $8.32
| Facility | | $8.32 | $8.32 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $7.41 / $14.45
| Professional | | $4.90 | $7.41 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $7.08 / $10.47
| Facility | | $3.16 | $7.08 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.98 / $9.33
| Professional | | $2.69 | $3.98 | $9.33 |