- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $51.29 / $81.28
| Facility | | $8.91 | $51.29 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.25 / $14.13
| Professional | | $4.37 | $5.25 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $15.14 / $20.89
| Facility | | $9.33 | $15.14 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.61 / $10.96
| Professional | | $3.98 | $6.61 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $12.88 / $14.45
| Professional | | $11.75 | $12.88 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $15.49 / $72.44
| Facility | | $5.75 | $15.49 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.92 / $13.49
| Professional | | $5.01 | $6.92 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $11.48
| Facility | | $5.75 | $5.75 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $8.13
| Professional | | $5.75 | $5.75 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $8.32 / $17.38
| Facility | | $5.62 | $8.32 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.92 / $79.43
| Professional | | $5.75 | $6.92 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $17.38 / $23.99
| Facility | | $8.71 | $17.38 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.89 / $7.41
| Professional | | $4.37 | $5.89 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $6.92 / $9.33
| Facility | | $3.63 | $6.92 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $3.31 / $8.51
| Professional | | $2.45 | $3.31 | $8.51 |