- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $46.77 / $102.33
| Facility | | $6.17 | $46.77 | $102.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.75 / $8.51
| Professional | | $4.79 | $5.75 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.47 / $28.18
| Professional | | $4.27 | $4.47 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $14.45 / $20.42
| Facility | | $11.48 | $14.45 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.17 / $5.89
| Professional | | $3.89 | $4.17 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $13.49 / $29.51
| Facility | | $4.47 | $13.49 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $4.47 / $9.77
| Professional | | $3.39 | $4.47 | $9.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $12.59 / $93.33
| Professional | | $5.37 | $12.59 | $93.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.89 / $12.59
| Facility | | $5.13 | $5.89 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.37 / $6.03
| Professional | | $5.25 | $5.37 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $8.51 / $11.22
| Facility | | $3.39 | $8.51 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.47 / $10.00
| Professional | | $3.24 | $4.47 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $100.00
| Facility | | $60.26 | $60.26 | $100.00 |