- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $51.29 / $165.96
| Facility | | $6.31 | $51.29 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $6.03 / $8.32
| Professional | | $4.07 | $6.03 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $4.07 / $6.92
| Professional | | $2.95 | $4.07 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $20.89 / $39.81
| Facility | | $7.41 | $20.89 | $39.81 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.07 / $5.50
| Professional | | $3.80 | $4.07 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $10.96 / $97.72
| Facility | | $6.31 | $10.96 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $6.17 / $11.75
| Professional | | $4.07 | $6.17 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $6.92
| Facility | | $6.76 | $6.76 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $15.14 / $36.31
| Facility | | $7.94 | $15.14 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.25 / $11.48
| Professional | | $3.89 | $5.25 | $11.48 |
- 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
- $6.17 / $10.00 / $11.22
| Professional | | $6.17 | $10.00 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $12.02 / $123.03
| Facility | | $5.25 | $12.02 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.17 / $11.22
| Professional | | $3.98 | $6.17 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.75 / $5.75
| Professional | | $5.13 | $5.75 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $147.91 / $338.84 / $338.84
| Facility | | $147.91 | $338.84 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $6.92 / $19.95
| Facility | | $5.50 | $6.92 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.25 / $11.22
| Professional | | $3.89 | $5.25 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $6.92 / $8.32
| Facility | | $3.09 | $6.92 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $3.98 / $6.92
| Professional | | $2.88 | $3.98 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.55 / $4.79
| Professional | | $2.69 | $3.55 | $4.79 |