- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $25.12 / $83.18
| Facility | | $3.47 | $25.12 | $83.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.55 / $7.94
| Professional | | $2.00 | $3.55 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.16 / $3.16
| Professional | | $2.19 | $3.16 | $3.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $15.85 / $27.54
| Facility | | $6.17 | $15.85 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.98 / $5.50
| Professional | | $2.51 | $3.98 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.75 / $8.51
| Facility | | $4.17 | $5.75 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.72 / $6.46
| Professional | | $2.75 | $3.72 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $3.63 / $4.57
| Facility | | $3.63 | $3.63 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $10.00 / $25.70
| Facility | | $5.37 | $10.00 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.80 / $7.59
| Professional | | $2.57 | $3.80 | $7.59 |
- 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
- $4.07 / $6.61 / $7.59
| Professional | | $4.07 | $6.61 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.90 / $58.88
| Facility | | $3.47 | $4.90 | $58.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $4.17 / $8.32
| Professional | | $2.45 | $4.17 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.89 / $3.89
| Professional | | $3.47 | $3.89 | $3.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $4.57 / $13.49
| Facility | | $3.72 | $4.57 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.55 / $7.59
| Professional | | $2.57 | $3.55 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $4.57 / $5.50
| Facility | | $2.04 | $4.57 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.63 / $4.57
| Professional | | $1.95 | $2.63 | $4.57 |