- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $16.60 / $57.54
| Facility | | $6.31 | $16.60 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.57 / $33.88
| Professional | | $3.02 | $4.57 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.16 / $3.55
| Professional | | $3.09 | $3.16 | $3.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $11.75 / $25.70
| Facility | | $2.95 | $11.75 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $4.47 / $16.98
| Professional | | $2.51 | $4.47 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.75 / $41.69 / $85.11
| Facility | | $11.75 | $41.69 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.75 / $16.60
| Professional | | $4.07 | $5.75 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $8.91 / $18.62
| Facility | | $3.89 | $8.91 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $5.75 / $12.88
| Professional | | $3.09 | $5.75 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.13 / $8.13
| Professional | | $4.57 | $5.13 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.13 / $11.48
| Professional | | $4.07 | $5.13 | $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
- $3.09 / $3.09 / $6.17
| Professional | | $3.09 | $3.09 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $6.17 / $16.22
| Facility | | $4.27 | $6.17 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.68 / $12.88
| Professional | | $3.09 | $4.68 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $17.78
| Professional | | $17.78 | $17.78 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.25 / $8.71
| Professional | | $4.07 | $5.25 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $3.47 / $5.13
| Facility | | $2.29 | $3.47 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $3.09 / $10.72
| Professional | | $2.14 | $3.09 | $10.72 |