- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $23.99 / $45.71
| Facility | | $6.92 | $23.99 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.37 / $33.88
| Professional | | $3.98 | $5.37 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $3.63 / $6.03
| Professional | | $3.63 | $3.63 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $30.20 / $363.08
| Facility | | $10.96 | $30.20 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $42.66 / $5,011.87
| Facility | | $31.62 | $42.66 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $6.03
| Professional | | $4.68 | $4.68 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $9.12 / $19.95
| Facility | | $4.37 | $9.12 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $7.59 / $14.45
| Professional | | $3.55 | $7.59 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $6.03 / $8.71
| Professional | | $2.82 | $6.03 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $6.03
| Facility | | $6.03 | $6.03 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $6.76 / $10.47
| Professional | | $5.89 | $6.76 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $15.85 / $37.15
| Facility | | $8.32 | $15.85 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $3.63 / $5.25
| Professional | | $3.63 | $3.63 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $26.92 / $104.71
| Facility | | $10.96 | $26.92 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $10.23 / $26.30
| Facility | | $4.27 | $10.23 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $10.72
| Professional | | $3.98 | $5.01 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $27.54
| Facility | | $17.38 | $17.38 | $27.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.03 / $20.42
| Facility | | $4.37 | $6.03 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.01 / $10.96
| Professional | | $4.37 | $5.01 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $6.03 / $7.24
| Facility | | $3.55 | $6.03 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.98 / $10.47
| Professional | | $2.69 | $3.98 | $10.47 |