- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $33.11 / $89.13
| Facility | | $7.94 | $33.11 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.01 / $28.84
| Professional | | $3.02 | $5.01 | $28.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $10.47 / $22.91
| Facility | | $2.57 | $10.47 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.98 / $15.14
| Professional | | $2.24 | $3.98 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $37.15 / $75.86
| Facility | | $10.47 | $37.15 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $5.13 / $14.79
| Professional | | $3.63 | $5.13 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $7.94 / $16.60
| Facility | | $3.47 | $7.94 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $5.37 / $10.96
| Professional | | $2.69 | $5.37 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.47 / $7.24
| Professional | | $3.80 | $4.47 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.47 / $10.47
| Professional | | $3.63 | $4.47 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $100.00
| Facility | | $60.26 | $60.26 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $5.37
| Professional | | $2.69 | $2.69 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $5.37 / $12.88
| Facility | | $3.72 | $5.37 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.17 / $10.96
| Professional | | $2.69 | $4.17 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $15.85 / $15.85
| Professional | | $15.85 | $15.85 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $4.57 / $7.76
| Professional | | $3.63 | $4.57 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $3.09 / $4.47
| Facility | | $2.04 | $3.09 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $2.69 / $9.33
| Professional | | $1.91 | $2.69 | $9.33 |