- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $61.66 / $97.72
| Facility | | $10.00 | $61.66 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.31 / $19.05
| Professional | | $3.02 | $3.31 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $9.77 / $10.00
| Facility | | $7.94 | $9.77 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $1.82 / $14.79
| Professional | | $1.82 | $1.82 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $2.45 / $3.89
| Facility | | $2.45 | $2.45 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $3.63 / $3.63
| Professional | | $3.63 | $3.63 | $3.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.00 / $11.48 / $18.62
| Facility | | $10.00 | $11.48 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.13 / $11.48
| Professional | | $4.17 | $5.13 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $7.94 / $29.51
| Facility | | $3.24 | $7.94 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $38.02 / $61.66
| Facility | | $3.24 | $38.02 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.09 / $9.12
| Professional | | $2.19 | $3.09 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $12.88 / $64.57
| Professional | | $1.82 | $12.88 | $64.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $10.47
| Facility | | $4.37 | $4.37 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $6.03 / $10.47
| Professional | | $2.75 | $6.03 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $9.33 / $12.88
| Professional | | $4.90 | $9.33 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.41 / $79.43
| Facility | | $7.41 | $7.41 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.45 / $3.63
| Professional | | $1.95 | $2.45 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $18.62
| Professional | | $7.76 | $7.76 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.38 / $18.62 / $24.55
| Professional | | $17.38 | $18.62 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $3.24 / $4.37
| Facility | | $1.82 | $3.24 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $2.95 / $8.32
| Professional | | $1.82 | $2.95 | $8.32 |