- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $23.99 / $64.57
| Facility | | $5.62 | $23.99 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.13 / $19.95
| Professional | | $3.02 | $5.13 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $2.19 / $3.98
| Professional | | $1.74 | $2.19 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $10.23 / $21.88
| Facility | | $3.02 | $10.23 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.74 / $3.31 / $9.12
| Professional | | $1.74 | $3.31 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $26.30 / $56.23
| Facility | | $8.71 | $26.30 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.72 / $11.48
| Professional | | $2.57 | $3.72 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $7.76 / $14.79
| Facility | | $3.09 | $7.76 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $5.01 / $8.51
| Professional | | $2.40 | $5.01 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $4.37 / $7.08
| Professional | | $2.95 | $4.37 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.37 / $10.00
| Professional | | $3.47 | $4.37 | $10.00 |
- 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
- $5.25 / $5.25 / $5.25
| Professional | | $5.25 | $5.25 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $5.01 / $11.48
| Facility | | $3.16 | $5.01 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $4.17 / $8.71
| Professional | | $2.40 | $4.17 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.49 / $15.49 / $15.49
| Professional | | $15.49 | $15.49 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $4.47 / $7.41
| Professional | | $2.95 | $4.47 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.63 / $4.37
| Facility | | $1.95 | $2.63 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.16 / $8.32
| Professional | | $2.63 | $3.16 | $8.32 |