- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $56.23 / $213.80
| Facility | | $8.71 | $56.23 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $7.59 / $17.38
| Professional | | $5.62 | $7.59 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.25 / $8.71
| Professional | | $3.89 | $5.25 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $26.92 / $50.12
| Facility | | $9.55 | $26.92 | $50.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.01 / $6.17
| Professional | | $4.79 | $5.01 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $11.75 / $44.67
| Facility | | $6.61 | $11.75 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $9.12 / $14.79
| Professional | | $6.17 | $9.12 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $8.71
| Facility | | $8.71 | $8.71 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $19.05 / $46.77
| Facility | | $10.23 | $19.05 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $8.13 / $15.49
| Professional | | $5.01 | $8.13 | $15.49 |
- 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
- $7.41 / $11.22 / $16.22
| Professional | | $7.41 | $11.22 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $28.18 / $181.97
| Facility | | $6.61 | $28.18 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.76 / $16.22
| Professional | | $5.01 | $7.76 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $7.41 / $7.41
| Professional | | $6.61 | $7.41 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $208.93 / $208.93
| Facility | | $89.13 | $208.93 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $8.71 / $25.70
| Facility | | $6.92 | $8.71 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $8.13 / $15.14
| Professional | | $5.01 | $8.13 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $8.71 / $10.47
| Facility | | $3.63 | $8.71 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $5.13 / $10.96
| Professional | | $3.63 | $5.13 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $4.57 / $8.71
| Professional | | $3.39 | $4.57 | $8.71 |