- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $47.86 / $93.33
| Facility | | $13.49 | $47.86 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.91 / $38.90
| Professional | | $6.03 | $8.91 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.90 / $5.75
| Professional | | $3.80 | $4.90 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $19.05 / $40.74
| Facility | | $7.08 | $19.05 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $7.24 / $23.44
| Professional | | $4.07 | $7.24 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $58.88 / $128.82
| Facility | | $19.05 | $58.88 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $9.33 / $26.92
| Professional | | $6.46 | $9.33 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $14.45 / $30.20
| Facility | | $6.17 | $14.45 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $10.00 / $18.62
| Professional | | $5.37 | $10.00 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $8.13 / $13.18
| Professional | | $6.76 | $8.13 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $8.13 / $18.62
| Professional | | $6.61 | $8.13 | $18.62 |
- 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
- $4.90 / $4.90 / $9.77
| Professional | | $4.90 | $4.90 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $9.77 / $25.70
| Facility | | $6.92 | $9.77 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $9.55 / $20.89
| Professional | | $5.37 | $9.55 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $28.84 / $28.84 / $28.84
| Professional | | $28.84 | $28.84 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $8.32 / $13.80
| Professional | | $6.61 | $8.32 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $5.62 / $8.13
| Facility | | $3.72 | $5.62 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.90 / $16.98
| Professional | | $3.47 | $4.90 | $16.98 |