- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $25.70 / $72.44
| Facility | | $12.02 | $25.70 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $16.22 / $39.81
| Professional | | $3.02 | $16.22 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $12.88 / $15.14
| Professional | | $3.02 | $12.88 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $25.12 / $47.86
| Facility | | $19.05 | $25.12 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $9.33 / $10.00
| Professional | | $6.46 | $9.33 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $48.98 / $48.98 / $48.98
| Facility | | $48.98 | $48.98 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $11.75 / $14.79
| Professional | | $7.08 | $11.75 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $22.91 / $83.18
| Facility | | $3.98 | $22.91 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.63 / $11.22
| Professional | | $2.69 | $3.63 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $12.30
| Professional | | $7.41 | $7.41 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $7.41
| Facility | | $7.41 | $7.41 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.63 / $7.94
| Facility | | $2.51 | $3.63 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.63 / $6.61
| Professional | | $3.47 | $3.63 | $6.61 |