- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $34.67 / $147.91
| Facility | | $7.08 | $34.67 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.89 / $12.02
| Professional | | $5.01 | $5.89 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $4.37
| Professional | | $3.98 | $3.98 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $6.61 / $7.76
| Facility | | $5.89 | $6.61 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $6.61 / $9.55
| Professional | | $5.50 | $6.61 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $8.13 / $16.98
| Facility | | $4.57 | $8.13 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $6.76 / $12.88
| Professional | | $3.47 | $6.76 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $28.18 / $63.10
| Facility | | $6.61 | $28.18 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $9.33
| Professional | | $3.98 | $3.98 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.16 / $3.98
| Professional | | $3.16 | $3.16 | $3.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $5.37 / $8.13
| Facility | | $2.75 | $5.37 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.89 / $9.33
| Professional | | $2.75 | $3.89 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $6.61
| Professional | | $3.98 | $3.98 | $6.61 |