- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $54.95 / $181.97
| Facility | | $10.47 | $54.95 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.51 / $51.29
| Professional | | $7.08 | $8.51 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $6.46 / $6.46
| Professional | | $4.17 | $6.46 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $9.77 / $16.98
| Facility | | $8.51 | $9.77 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.75 / $12.02
| Professional | | $4.57 | $5.75 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $6.31 / $6.31
| Facility | | $6.31 | $6.31 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $7.41
| Professional | | $7.41 | $7.41 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $9.77 / $11.75
| Facility | | $9.33 | $9.77 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $9.33 / $12.59
| Professional | | $6.03 | $9.33 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $12.02 / $38.90
| Facility | | $6.17 | $12.02 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $6.17 / $17.78
| Professional | | $4.79 | $6.17 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $26.30 / $87.10
| Facility | | $7.76 | $26.30 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $6.92 / $25.12
| Professional | | $3.24 | $6.92 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $8.32 / $11.48
| Professional | | $6.92 | $8.32 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $11.22
| Facility | | $11.22 | $11.22 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $10.23 / $20.42
| Professional | | $6.46 | $10.23 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $9.33 / $13.80
| Facility | | $4.68 | $9.33 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.62 / $12.88
| Professional | | $3.89 | $5.62 | $12.88 |