- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $87.10 / $263.03
| Facility | | $10.96 | $87.10 | $263.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.62 / $10.47
| Professional | | $3.98 | $5.62 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.98 / $6.46
| Professional | | $3.09 | $3.98 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $16.98 / $36.31
| Facility | | $4.17 | $16.98 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.57 / $5.75
| Professional | | $4.17 | $4.57 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $9.12 / $64.57
| Facility | | $4.79 | $9.12 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $6.61 / $10.96
| Professional | | $4.57 | $6.61 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.76 / $6.76
| Facility | | $6.46 | $6.76 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $14.45 / $34.67
| Facility | | $7.59 | $14.45 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $7.24 / $10.96
| Professional | | $4.07 | $7.24 | $10.96 |
- 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
- $5.50 / $8.51 / $14.45
| Professional | | $5.50 | $8.51 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $64.57 / $234.42
| Facility | | $5.25 | $64.57 | $234.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $5.75 / $11.75
| Professional | | $3.89 | $5.75 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $5.37 / $5.37
| Professional | | $4.90 | $5.37 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $223.87 / $223.87
| Facility | | $77.62 | $223.87 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.46 / $19.95
| Facility | | $5.13 | $6.46 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $7.08 / $11.48
| Professional | | $4.07 | $7.08 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $6.46 / $7.76
| Facility | | $2.69 | $6.46 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.80 / $9.12
| Professional | | $2.69 | $3.80 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.39 / $6.46
| Professional | | $2.51 | $3.39 | $6.46 |