- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.79 / $41.69 / $93.33
| Facility | | $14.79 | $41.69 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.94 / $31.62
| Professional | | $6.03 | $7.94 | $31.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $22.91 / $48.98
| Facility | | $4.47 | $22.91 | $48.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $7.08 / $23.99
| Professional | | $3.89 | $7.08 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.05 / $54.95 / $112.20
| Facility | | $19.05 | $54.95 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $8.13 / $25.70
| Professional | | $5.75 | $8.13 | $25.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $16.98 / $33.11
| Facility | | $6.76 | $16.98 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $9.33 / $19.50
| Professional | | $5.25 | $9.33 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $9.77 / $15.49
| Professional | | $6.46 | $9.77 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $9.77 / $21.88
| Professional | | $7.76 | $9.77 | $21.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $64.57 / $64.57 / $102.33
| Facility | | $64.57 | $64.57 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $4.90 / $9.77
| Professional | | $4.90 | $4.90 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $11.22 / $25.70
| Facility | | $7.08 | $11.22 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $7.41 / $19.50
| Professional | | $5.25 | $7.41 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $33.88 / $33.88
| Professional | | $33.88 | $33.88 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $10.00 / $16.60
| Professional | | $7.76 | $10.00 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.89 / $9.77
| Facility | | $4.37 | $5.89 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.89 / $18.62
| Professional | | $4.07 | $5.89 | $18.62 |