- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $39.81 / $109.65
| Facility | | $5.01 | $39.81 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.37 / $6.03
| Professional | | $3.02 | $4.37 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $3.39 / $3.39
| Professional | | $2.45 | $3.39 | $3.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $15.14 / $29.51
| Facility | | $5.50 | $15.14 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $4.47 / $5.50
| Professional | | $2.75 | $4.47 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $7.76 / $31.62
| Facility | | $4.68 | $7.76 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $5.01 / $8.13
| Professional | | $3.55 | $5.01 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $5.01
| Facility | | $5.01 | $5.01 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $10.96 / $26.92
| Facility | | $5.62 | $10.96 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.63 / $9.77
| Professional | | $2.75 | $3.63 | $9.77 |
- 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
- $4.57 / $7.24 / $8.51
| Professional | | $4.57 | $7.24 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $6.17 / $89.13
| Facility | | $3.89 | $6.17 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.47 / $8.71
| Professional | | $3.02 | $4.47 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.27 / $4.27
| Professional | | $3.80 | $4.27 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $14.79
| Facility | | $3.98 | $5.01 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.63 / $7.94
| Professional | | $2.75 | $3.63 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $5.01 / $6.03
| Facility | | $2.14 | $5.01 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.82 / $5.01
| Professional | | $2.14 | $2.82 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.63 / $3.47
| Professional | | $1.95 | $2.63 | $3.47 |