- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $22.91 / $85.11
| Facility | | $3.89 | $22.91 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $9.33 / $19.05
| Professional | | $7.94 | $9.33 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $7.08
| Professional | | $6.46 | $6.46 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $10.72 / $12.59
| Facility | | $9.55 | $10.72 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $10.72 / $15.14
| Professional | | $8.91 | $10.72 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $13.18 / $27.54
| Facility | | $7.59 | $13.18 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $11.22 / $21.38
| Professional | | $5.62 | $11.22 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $45.71 / $102.33
| Facility | | $10.72 | $45.71 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $15.14
| Professional | | $6.46 | $6.46 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.29 / $5.13 / $6.46
| Professional | | $1.29 | $5.13 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $8.71 / $13.18
| Facility | | $4.47 | $8.71 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.31 / $15.14
| Professional | | $4.47 | $6.31 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $10.72
| Professional | | $6.46 | $6.46 | $10.72 |