- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $26.30 / $102.33
| Facility | | $7.08 | $26.30 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.01 / $28.18
| Professional | | $3.02 | $5.01 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $2.69 / $3.09
| Professional | | $1.51 | $2.69 | $3.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $10.47 / $22.39
| Facility | | $2.57 | $10.47 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.98 / $12.88
| Professional | | $2.19 | $3.98 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $36.31 / $75.86
| Facility | | $10.23 | $36.31 | $75.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $5.13 / $14.45
| Professional | | $3.55 | $5.13 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $7.94 / $16.60
| Facility | | $3.39 | $7.94 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $5.37 / $10.96
| Professional | | $2.69 | $5.37 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.47 / $7.24
| Professional | | $3.80 | $4.47 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.96 / $10.96 / $10.96
| Professional | | $10.96 | $10.96 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $4.47 / $10.23
| Professional | | $3.55 | $4.47 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $79.43
| Facility | | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $5.37
| Professional | | $5.37 | $5.37 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $5.37 / $13.80
| Facility | | $3.80 | $5.37 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.07 / $10.96
| Professional | | $2.69 | $4.07 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.85 / $15.85 / $15.85
| Professional | | $15.85 | $15.85 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $4.27 / $6.46
| Professional | | $3.55 | $4.27 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $3.09 / $4.47
| Facility | | $2.04 | $3.09 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.69 / $9.12
| Professional | | $1.86 | $2.69 | $9.12 |