- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $25.12 / $97.72
| Facility | | $6.31 | $25.12 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.25 / $56.23
| Professional | | $3.98 | $5.25 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $3.98 / $7.76
| Professional | | $2.88 | $3.98 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $6.17 / $10.72
| Facility | | $5.25 | $6.17 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $3.47 / $5.37
| Professional | | $2.88 | $3.47 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $3.89 / $4.57
| Facility | | $3.89 | $3.89 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.07 / $4.57
| Professional | | $4.07 | $4.07 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.03 / $7.24
| Facility | | $5.75 | $6.03 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $5.75 / $7.76
| Professional | | $3.80 | $5.75 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $7.59 / $24.55
| Facility | | $3.89 | $7.59 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $3.98 / $11.22
| Professional | | $2.95 | $3.98 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $20.89 / $100.00
| Facility | | $4.68 | $20.89 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $4.68 / $10.96
| Professional | | $2.29 | $4.68 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.25 / $7.08
| Professional | | $4.37 | $5.25 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $9.55 / $12.59
| Facility | | $6.92 | $9.55 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $6.31 / $11.75
| Professional | | $4.07 | $6.31 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $5.75 / $8.71
| Facility | | $2.88 | $5.75 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $3.47 / $8.13
| Professional | | $2.45 | $3.47 | $8.13 |