- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $48.98 / $181.97
| Facility | | $10.23 | $48.98 | $181.97 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.01 / $28.84
| Professional | | $3.02 | $5.01 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $2.34 / $4.27
| Professional | | $1.58 | $2.34 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $10.96 / $23.99
| Facility | | $2.69 | $10.96 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $4.17 / $14.45
| Professional | | $2.34 | $4.17 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $38.90 / $79.43
| Facility | | $10.96 | $38.90 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $5.37 / $15.49
| Professional | | $3.80 | $5.37 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $8.32 / $17.38
| Facility | | $3.63 | $8.32 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.75 / $11.22
| Professional | | $3.02 | $5.75 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.79 / $7.59
| Professional | | $4.17 | $4.79 | $7.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.79 / $10.96
| Professional | | $3.80 | $4.79 | $10.96 |
- 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
- $4.27 / $6.61 / $14.13
| Professional | | $4.27 | $6.61 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $2.82 / $5.75
| Professional | | $2.82 | $2.82 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.75 / $14.13
| Facility | | $4.07 | $5.75 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $4.79 / $11.22
| Professional | | $2.88 | $4.79 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $16.60 / $16.60 / $16.60
| Professional | | $16.60 | $16.60 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.79 / $8.13
| Professional | | $3.80 | $4.79 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.24 / $4.79
| Facility | | $2.00 | $3.24 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.82 / $12.88
| Professional | | $2.00 | $2.82 | $12.88 |