- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.13 / $26.30 / $32.36
| Facility | | $14.13 | $26.30 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $14.13
| Professional | | $7.08 | $8.91 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $25.70 / $31.62 / $32.36
| Facility | | $25.70 | $31.62 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $5.89 / $41.69
| Professional | | $5.89 | $5.89 | $41.69 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $8.13
| Facility | | $8.13 | $8.13 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $38.02 / $60.26
| Facility | | $32.36 | $38.02 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $16.98 / $37.15
| Professional | | $13.49 | $16.98 | $37.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $25.70 / $48.98
| Facility | | $10.47 | $25.70 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $11.22 / $81.28
| Facility | | $9.33 | $11.22 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.08 / $18.20
| Professional | | $5.01 | $7.08 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $17.78 / $64.57
| Professional | | $10.00 | $17.78 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $14.13 / $18.20
| Facility | | $12.88 | $14.13 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.02 / $33.88
| Professional | | $8.91 | $12.02 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $30.90 / $50.12
| Professional | | $15.85 | $30.90 | $50.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $50.12 / $50.12 / $81.28
| Facility | | $50.12 | $50.12 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $7.76 / $11.48
| Professional | | $6.31 | $7.76 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $6.31 / $25.12
| Professional | | $6.31 | $6.31 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $20.89 / $64.57
| Professional | | $6.31 | $20.89 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $10.47 / $14.13
| Facility | | $5.89 | $10.47 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.08 / $19.50
| Professional | | $5.01 | $7.08 | $19.50 |