- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $34.67 / $81.28
| Facility | | $3.72 | $34.67 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.14 / $6.31
| Professional | | $1.00 | $2.14 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.12 / $1.45 / $1.62
| Professional | | $1.12 | $1.45 | $1.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $6.17 / $13.18
| Facility | | $1.86 | $6.17 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.55 / $1.66 / $5.50
| Professional | | $1.55 | $1.66 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $3.55 / $15.49
| Facility | | $2.14 | $3.55 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $2.34 / $4.07
| Professional | | $1.66 | $2.34 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.34 / $2.34
| Facility | | $2.34 | $2.34 | $2.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $5.25 / $12.88
| Facility | | $2.75 | $5.25 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $2.45 / $3.98
| Professional | | $1.41 | $2.45 | $3.98 |
- 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
- $1.95 / $2.88 / $4.68
| Professional | | $1.95 | $2.88 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $10.23 / $70.79
| Facility | | $1.95 | $10.23 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.00 / $2.14 / $5.13
| Professional | | $1.00 | $2.14 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $2.00 / $2.00
| Professional | | $1.78 | $2.00 | $2.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $102.33 / $102.33 / $107.15
| Facility | | $102.33 | $102.33 | $107.15 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $2.34 / $7.94
| Facility | | $1.91 | $2.34 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $2.24 / $3.80
| Professional | | $1.41 | $2.24 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.07 / $2.34 / $2.82
| Facility | | $1.07 | $2.34 | $2.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $1.95 / $3.24
| Professional | | $1.41 | $1.95 | $3.24 |