- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $34.67 / $117.49
| Facility | | $8.51 | $34.67 | $117.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $7.94 / $18.20
| Professional | | $6.31 | $7.94 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $5.37 / $16.60
| Professional | | $3.80 | $5.37 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $13.49 / $18.20
| Facility | | $9.55 | $13.49 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $8.13 / $9.12
| Professional | | $6.76 | $8.13 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $19.95 / $32.36
| Facility | | $9.33 | $19.95 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $9.77 / $14.13
| Professional | | $5.62 | $9.77 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.94 / $9.55
| Professional | | $5.75 | $7.94 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $18.20
| Facility | | $9.12 | $9.12 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $9.12 / $11.22
| Professional | | $9.12 | $9.12 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $15.85 / $24.55
| Facility | | $9.12 | $15.85 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.13 / $10.72
| Professional | | $8.13 | $8.13 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $13.49 / $23.99
| Facility | | $10.47 | $13.49 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $8.13 / $9.12
| Professional | | $6.76 | $8.13 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $10.72 / $10.72
| Facility | | $8.13 | $10.72 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $5.25 / $12.59
| Professional | | $3.80 | $5.25 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.68 / $16.22
| Professional | | $4.07 | $4.68 | $16.22 |