- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $43.65 / $141.25
| Facility | | $7.76 | $43.65 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.27 / $13.80
| Professional | | $3.02 | $4.27 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.82 / $3.31
| Professional | | $2.34 | $2.82 | $3.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.79 / $5.62
| Facility | | $4.17 | $4.79 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.79 / $6.92
| Professional | | $3.89 | $4.79 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $5.75 / $12.30
| Facility | | $3.31 | $5.75 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $5.01 / $9.33
| Professional | | $2.57 | $5.01 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $20.42 / $44.67
| Facility | | $4.68 | $20.42 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $2.82 / $6.61
| Professional | | $2.82 | $2.82 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $2.29 / $2.82
| Professional | | $2.29 | $2.29 | $2.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.89 / $5.89
| Facility | | $2.00 | $3.89 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.75 / $6.61
| Professional | | $2.00 | $2.75 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $2.82 / $4.79
| Professional | | $2.82 | $2.82 | $4.79 |