- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $29.51 / $89.13
| Facility | | $6.61 | $29.51 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.75 / $30.90
| Professional | | $4.79 | $5.75 | $30.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.47 / $8.71
| Professional | | $3.24 | $4.47 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $6.76 / $12.02
| Facility | | $5.89 | $6.76 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.89 / $8.32
| Professional | | $3.09 | $3.89 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $4.37 / $4.37
| Facility | | $4.37 | $4.37 | $4.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $4.57 / $5.13
| Professional | | $4.57 | $4.57 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.76 / $8.13
| Facility | | $6.46 | $6.76 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $6.46 / $8.71
| Professional | | $4.17 | $6.46 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $7.76 / $26.92
| Facility | | $4.37 | $7.76 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $6.61 / $12.30
| Professional | | $3.31 | $6.61 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $26.92 / $66.07
| Facility | | $8.13 | $26.92 | $66.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $5.25 / $18.62
| Professional | | $2.57 | $5.25 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.75 / $7.94
| Professional | | $4.79 | $5.75 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $14.13
| Facility | | $7.76 | $7.76 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $7.08 / $13.18
| Professional | | $4.79 | $7.08 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $6.46 / $9.77
| Facility | | $2.34 | $6.46 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.89 / $9.55
| Professional | | $2.69 | $3.89 | $9.55 |