- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $22.39 / $104.71
| Facility | | $4.17 | $22.39 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.27 / $6.17
| Professional | | $3.02 | $4.27 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.47 / $3.47
| Professional | | $2.69 | $3.47 | $3.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $17.78 / $30.20
| Facility | | $6.03 | $17.78 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.37 / $5.50
| Professional | | $3.09 | $4.37 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $8.71 / $33.88
| Facility | | $5.13 | $8.71 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.62 / $8.32
| Professional | | $3.89 | $5.62 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $5.62
| Facility | | $5.62 | $5.62 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $11.22 / $28.18
| Facility | | $5.50 | $11.22 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.47 / $8.32
| Professional | | $2.82 | $3.47 | $8.32 |
- 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
- $4.90 / $7.08 / $9.12
| Professional | | $4.90 | $7.08 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.62 / $42.66
| Facility | | $4.17 | $5.62 | $42.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.01 / $8.91
| Professional | | $3.02 | $5.01 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.68 / $4.68
| Professional | | $4.17 | $4.68 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.62 / $16.22
| Facility | | $4.27 | $5.62 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.47 / $7.94
| Professional | | $2.82 | $3.47 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $5.62 / $6.61
| Facility | | $2.34 | $5.62 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.82 / $4.68
| Professional | | $2.34 | $2.82 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $2.88 / $5.62
| Professional | | $2.19 | $2.88 | $5.62 |