- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $39.81 / $77.62
| Facility | | $14.13 | $39.81 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.13 / $60.26
| Professional | | $6.03 | $8.13 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $21.88 / $46.77
| Facility | | $4.37 | $21.88 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $6.92 / $22.91
| Professional | | $3.72 | $6.92 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $53.70 / $109.65
| Facility | | $18.20 | $53.70 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $7.76 / $24.55
| Professional | | $5.50 | $7.76 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $16.60 / $31.62
| Facility | | $6.46 | $16.60 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $9.12 / $18.62
| Professional | | $5.01 | $9.12 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.33 / $14.79
| Professional | | $7.41 | $9.33 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.33 / $33.11
| Professional | | $7.41 | $9.33 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $70.79 / $100.00
| Facility | | $70.79 | $70.79 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $9.33
| Professional | | $4.68 | $4.68 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $10.72 / $27.54
| Facility | | $6.76 | $10.72 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.24 / $18.62
| Professional | | $5.01 | $7.24 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $33.11 / $33.11
| Professional | | $33.11 | $33.11 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.55 / $15.85
| Professional | | $7.41 | $9.55 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.62 / $9.33
| Facility | | $4.17 | $5.62 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.62 / $17.78
| Professional | | $3.89 | $5.62 | $17.78 |