- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $63.10 / $223.87
| Facility | | $10.47 | $63.10 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.75 / $14.79
| Professional | | $5.01 | $5.75 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.89 / $4.47
| Professional | | $3.24 | $3.89 | $4.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.46 / $7.59
| Facility | | $5.75 | $6.46 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $6.46 / $9.55
| Professional | | $5.37 | $6.46 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $7.24 / $16.60
| Facility | | $4.47 | $7.24 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $6.76 / $12.30
| Professional | | $3.47 | $6.76 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $28.18 / $61.66
| Facility | | $6.46 | $28.18 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $9.12 / $12.88
| Professional | | $3.31 | $9.12 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.16 / $3.89
| Professional | | $3.16 | $3.16 | $3.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $5.37 / $8.13
| Facility | | $2.75 | $5.37 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.80 / $9.12
| Professional | | $2.75 | $3.80 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $3.89 / $3.89
| Professional | | $3.89 | $3.89 | $3.89 |