- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $14.45 / $40.74
| Facility | | $5.37 | $14.45 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.03 / $10.96
| Professional | | $3.98 | $6.03 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $10.23
| Facility | | $7.76 | $7.76 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $17.78 / $44.67
| Facility | | $10.23 | $17.78 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.46 / $14.79
| Professional | | $4.47 | $6.46 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $112.20
| Facility | | $85.11 | $85.11 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $15.14
| Professional | | $15.14 | $15.14 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.76 / $28.18
| Facility | | $5.75 | $7.76 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $7.76 / $14.45
| Professional | | $3.98 | $7.76 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.46 / $6.46
| Professional | | $5.75 | $6.46 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $8.32 / $28.18
| Facility | | $6.17 | $8.32 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.46 / $13.18
| Professional | | $4.47 | $6.46 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $7.76 / $9.33
| Facility | | $3.47 | $7.76 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $5.01 / $10.47
| Professional | | $3.24 | $5.01 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $5.37
| Professional | | $3.02 | $3.98 | $5.37 |