- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $47.86 / $107.15
| Facility | | $8.13 | $47.86 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $8.51 / $31.62
| Professional | | $5.13 | $8.51 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $9.55 / $14.13
| Professional | | $3.63 | $9.55 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $12.88 / $17.38
| Facility | | $8.71 | $12.88 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.76 / $8.71
| Professional | | $6.46 | $7.76 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $19.05 / $22.91
| Facility | | $8.13 | $19.05 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $8.91 / $12.30
| Professional | | $4.37 | $8.91 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $7.59 / $15.49
| Professional | | $5.50 | $7.59 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $17.38
| Facility | | $8.71 | $8.71 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $11.75
| Professional | | $8.71 | $8.71 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $13.80 / $23.44
| Facility | | $8.71 | $13.80 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $10.23
| Professional | | $7.76 | $7.76 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $12.88 / $22.91
| Facility | | $8.71 | $12.88 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.76 / $8.71
| Professional | | $6.46 | $7.76 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $10.23 / $10.23
| Facility | | $7.76 | $10.23 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.50 / $10.00
| Professional | | $5.13 | $5.50 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.47 / $5.89
| Professional | | $4.47 | $4.47 | $5.89 |