- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.38 / $89.13 / $407.38
| Facility | | $21.38 | $89.13 | $407.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.08 / $38.02
| Professional | | $5.75 | $7.08 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.68 / $5.37
| Professional | | $3.89 | $4.68 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $7.76 / $9.12
| Facility | | $6.92 | $7.76 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $7.76 / $11.22
| Professional | | $6.17 | $7.76 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $9.55 / $19.95
| Facility | | $5.37 | $9.55 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $7.94 / $12.59
| Professional | | $4.07 | $7.94 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $33.11 / $74.13
| Facility | | $7.76 | $33.11 | $74.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $10.96 / $15.49
| Professional | | $3.89 | $10.96 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $3.80 / $4.68
| Professional | | $3.72 | $3.80 | $4.68 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $6.03 / $9.55
| Facility | | $3.24 | $6.03 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.57 / $12.30
| Professional | | $3.24 | $4.57 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $4.68
| Professional | | $4.68 | $4.68 | $4.68 |