- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $33.88 / $79.43
| Facility | | $7.94 | $33.88 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $41.69
| Professional | | $5.01 | $6.03 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.07 / $9.12
| Professional | | $3.02 | $4.07 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $7.08 / $12.30
| Facility | | $6.17 | $7.08 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $4.17 / $8.71
| Professional | | $3.31 | $4.17 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $4.57 / $4.57
| Facility | | $4.57 | $4.57 | $4.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $5.37
| Professional | | $4.68 | $4.68 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $7.08 / $8.32
| Facility | | $6.76 | $7.08 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.76 / $9.12
| Professional | | $4.37 | $6.76 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $8.71 / $26.92
| Facility | | $4.47 | $8.71 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.37 / $12.59
| Professional | | $3.47 | $4.37 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $36.31 / $72.44
| Facility | | $13.80 | $36.31 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $4.68 / $16.98
| Professional | | $2.51 | $4.68 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $8.32
| Professional | | $5.01 | $6.03 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $7.94
| Facility | | $7.94 | $7.94 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $7.08 / $13.80
| Professional | | $4.68 | $7.08 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $6.76 / $10.00
| Facility | | $3.39 | $6.76 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.98 / $16.22
| Professional | | $2.82 | $3.98 | $16.22 |