- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $36.31 / $77.62
| Facility | | $4.57 | $36.31 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $10.23
| Professional | | $3.02 | $3.98 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.09 / $14.45
| Professional | | $2.69 | $3.09 | $14.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $13.80 / $16.60
| Facility | | $7.94 | $13.80 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.88 / $4.07
| Professional | | $2.69 | $2.88 | $4.07 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $9.33 / $20.42
| Facility | | $3.09 | $9.33 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $3.16 / $6.76
| Professional | | $2.34 | $3.16 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $8.71 / $8.71
| Professional | | $7.76 | $8.71 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $4.07 / $8.71
| Facility | | $3.55 | $4.07 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $5.75 / $6.03
| Professional | | $3.63 | $5.75 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $4.47 / $7.76
| Facility | | $2.34 | $4.47 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.16 / $6.31
| Professional | | $2.24 | $3.16 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $79.43
| Facility | | $79.43 | $79.43 | $79.43 |