- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $51.29 / $125.89
| Facility | | $8.13 | $51.29 | $125.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $9.33 / $12.02
| Professional | | $6.92 | $9.33 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.61 / $7.41
| Professional | | $5.13 | $6.61 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $36.31 / $64.57
| Facility | | $14.45 | $36.31 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.89 / $10.47
| Professional | | $5.01 | $5.89 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $16.22 / $77.62
| Facility | | $8.13 | $16.22 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $10.23 / $17.38
| Professional | | $7.59 | $10.23 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $11.22 / $11.22
| Facility | | $10.72 | $11.22 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.59 / $23.99 / $58.88
| Facility | | $12.59 | $23.99 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.76 / $18.20
| Professional | | $6.03 | $7.76 | $18.20 |
- 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
- $9.55 / $15.49 / $17.78
| Professional | | $9.55 | $15.49 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $12.88 / $95.50
| Facility | | $8.13 | $12.88 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $9.55 / $17.38
| Professional | | $6.03 | $9.55 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $9.12 / $9.12
| Professional | | $8.13 | $9.12 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $251.19 / $524.81 / $588.84
| Facility | | $251.19 | $524.81 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.72 / $31.62
| Facility | | $8.51 | $10.72 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.76 / $18.20
| Professional | | $6.03 | $7.76 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $10.72 / $12.88
| Facility | | $4.79 | $10.72 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.31 / $10.72
| Professional | | $4.47 | $6.31 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.62 / $10.72
| Professional | | $4.17 | $5.62 | $10.72 |