- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $60.26 / $117.49
| Facility | | $9.33 | $60.26 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $14.13 / $27.54
| Professional | | $7.08 | $14.13 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $4.79
| Professional | | $3.47 | $3.47 | $4.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $30.20
| Facility | | $8.71 | $8.71 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $8.71 / $17.78
| Professional | | $3.47 | $8.71 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $12.88 / $14.13
| Facility | | $12.02 | $12.88 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $16.22 / $34.67
| Facility | | $8.32 | $16.22 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $8.13 / $16.22
| Professional | | $3.80 | $8.13 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $34.67 / $131.83
| Facility | | $9.33 | $34.67 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $7.76 / $11.22
| Professional | | $5.13 | $7.76 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $8.71 / $10.23
| Facility | | $3.63 | $8.71 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $7.08 / $12.59
| Professional | | $5.13 | $7.08 | $12.59 |