- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $14.13 / $154.88
| Facility | | $7.08 | $14.13 | $154.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.57 / $6.03
| Professional | | $3.02 | $4.57 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $13.80 / $14.13
| Facility | | $10.96 | $13.80 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.51 / $20.42
| Professional | | $2.51 | $2.51 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $3.02
| Facility | | $3.02 | $3.02 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $16.98 / $26.92
| Facility | | $14.45 | $16.98 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.24 / $15.85
| Professional | | $5.75 | $7.24 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $11.22 / $40.74
| Facility | | $4.57 | $11.22 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.90 / $69.18
| Facility | | $4.07 | $4.90 | $69.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.17 / $11.48
| Professional | | $3.02 | $4.17 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $10.47 / $64.57
| Professional | | $5.13 | $10.47 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $14.45
| Facility | | $6.17 | $6.17 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $8.32 / $14.45
| Professional | | $3.80 | $8.32 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $12.88 / $66.07
| Professional | | $6.61 | $12.88 | $66.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $100.00
| Facility | | $10.23 | $10.23 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.47 / $5.01
| Professional | | $2.69 | $3.47 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $10.96
| Professional | | $5.25 | $5.25 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $25.70 / $31.62
| Professional | | $5.25 | $25.70 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $4.57 / $6.17
| Facility | | $2.51 | $4.57 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $4.07 / $11.48
| Professional | | $2.14 | $4.07 | $11.48 |