- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.49 / $38.02 / $75.86
| Facility | | $13.49 | $38.02 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.94 / $51.29
| Professional | | $6.03 | $7.94 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $21.88 / $46.77
| Facility | | $5.37 | $21.88 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.92 / $19.95
| Professional | | $4.68 | $6.92 | $19.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $53.70 / $107.15
| Facility | | $17.78 | $53.70 | $107.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $7.76 / $24.55
| Professional | | $5.37 | $7.76 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $16.60 / $34.67
| Facility | | $6.61 | $16.60 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $8.71 / $19.50
| Professional | | $5.01 | $8.71 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $9.33 / $15.14
| Professional | | $7.41 | $9.33 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $9.33 / $21.38
| Professional | | $7.59 | $9.33 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $70.79 / $100.00
| Facility | | $70.79 | $70.79 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $9.33
| Professional | | $4.68 | $4.68 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $10.96 / $26.30
| Facility | | $6.92 | $10.96 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.24 / $19.50
| Professional | | $5.01 | $7.24 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $33.11 / $33.11
| Professional | | $33.11 | $33.11 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $9.55 / $16.22
| Professional | | $7.59 | $9.55 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.62 / $9.33
| Facility | | $4.27 | $5.62 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.27 / $18.62
| Professional | | $3.89 | $4.27 | $18.62 |