- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $42.66 / $89.13
| Facility | | $3.72 | $42.66 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.45 / $7.76
| Professional | | $2.00 | $2.45 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $1.86 / $74.13
| Professional | | $1.86 | $1.86 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $6.03 / $8.51
| Facility | | $4.79 | $6.03 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $1.78 / $2.45
| Professional | | $1.62 | $1.78 | $2.45 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $5.37 / $12.30
| Facility | | $1.86 | $5.37 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.82 / $4.17
| Professional | | $1.35 | $1.82 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.55 / $5.25
| Professional | | $2.24 | $3.55 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.34 / $5.25
| Facility | | $2.14 | $2.34 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $3.98 / $4.37
| Professional | | $2.14 | $3.98 | $4.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $109.65 / $109.65
| Facility | | $54.95 | $109.65 | $109.65 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.41 / $2.69 / $4.68
| Facility | | $1.41 | $2.69 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.91 / $3.80
| Professional | | $1.35 | $1.91 | $3.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $60.26
| Facility | | $60.26 | $60.26 | $60.26 |