- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $28.84 / $61.66
| Facility | | $10.47 | $28.84 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.47 / $33.11
| Professional | | $3.02 | $4.47 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $11.75 / $25.12
| Facility | | $2.82 | $11.75 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $4.37 / $16.60
| Professional | | $2.40 | $4.37 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $39.81 / $81.28
| Facility | | $11.22 | $39.81 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.62 / $15.85
| Professional | | $3.89 | $5.62 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $8.71 / $18.20
| Facility | | $3.80 | $8.71 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $5.75 / $12.30
| Professional | | $2.88 | $5.75 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.01 / $7.94
| Professional | | $4.37 | $5.01 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $11.48
| Professional | | $3.98 | $5.01 | $11.48 |
- 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
- $3.02 / $3.02 / $6.03
| Professional | | $3.02 | $3.02 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $6.03 / $15.85
| Facility | | $4.07 | $6.03 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $4.57 / $12.30
| Professional | | $2.88 | $4.57 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $17.38 / $17.38
| Professional | | $17.38 | $17.38 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.13 / $8.51
| Professional | | $3.98 | $5.13 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.47 / $5.01
| Facility | | $2.24 | $3.47 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $2.95 / $10.23
| Professional | | $2.09 | $2.95 | $10.23 |