- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $48.98 / $812.83
| Facility | | $7.24 | $48.98 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $54.95 / $549.54
| Professional | | $3.98 | $54.95 | $549.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.24 / $8.32
| Professional | | $2.63 | $3.24 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $12.02 / $26.30
| Facility | | $3.47 | $12.02 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $4.57 / $19.05
| Professional | | $2.57 | $4.57 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $42.66 / $87.10
| Facility | | $12.02 | $42.66 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.89 / $16.98
| Professional | | $4.17 | $5.89 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $9.12 / $19.05
| Facility | | $3.98 | $9.12 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $5.75 / $12.88
| Professional | | $3.09 | $5.75 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $5.25 / $8.32
| Professional | | $4.68 | $5.25 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.25 / $12.02
| Professional | | $4.17 | $5.25 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $134.90 / $134.90 / $134.90
| Facility | | $134.90 | $134.90 | $134.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $7.41 / $16.22
| Professional | | $4.47 | $7.41 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.16 / $6.31
| Professional | | $3.16 | $3.16 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.31 / $15.49
| Facility | | $4.37 | $6.31 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.79 / $12.88
| Professional | | $3.09 | $4.79 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $18.20 / $18.20 / $18.20
| Professional | | $18.20 | $18.20 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.37 / $8.91
| Professional | | $4.17 | $5.37 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $3.63 / $5.25
| Facility | | $2.34 | $3.63 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.16 / $10.72
| Professional | | $2.19 | $3.16 | $10.72 |