- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $14.13 / $51.29
| Facility | | $2.88 | $14.13 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.47 / $7.76
| Professional | | $2.00 | $3.47 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $2.34 / $3.89
| Professional | | $1.78 | $2.34 | $3.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $13.18 / $23.44
| Facility | | $5.37 | $13.18 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.29 / $5.50
| Professional | | $2.14 | $2.29 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $6.03 / $26.30
| Facility | | $3.63 | $6.03 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.63 / $6.31
| Professional | | $2.75 | $3.63 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.50 / $5.50
| Facility | | $3.89 | $5.50 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $8.71 / $21.38
| Facility | | $4.57 | $8.71 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $4.07 / $7.76
| Professional | | $2.34 | $4.07 | $7.76 |
- 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
- $3.47 / $5.62 / $6.46
| Professional | | $3.47 | $5.62 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $3.89 / $30.90
| Facility | | $2.95 | $3.89 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.55 / $7.08
| Professional | | $2.00 | $3.55 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $3.31 / $3.31
| Professional | | $2.95 | $3.31 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $22.91 / $22.91
| Facility | | $22.91 | $22.91 | $22.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.89 / $11.48
| Facility | | $3.16 | $3.89 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $3.89 / $6.46
| Professional | | $2.34 | $3.89 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $3.89 / $4.68
| Facility | | $1.78 | $3.89 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $3.24 / $4.27
| Professional | | $2.34 | $3.24 | $4.27 |