- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $16.60 / $56.23
| Facility | | $7.59 | $16.60 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.91 / $12.59
| Professional | | $6.03 | $8.91 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $7.08 / $7.24
| Professional | | $5.50 | $7.08 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.80 / $37.15 / $63.10
| Facility | | $13.80 | $37.15 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.31 / $11.48
| Professional | | $5.01 | $6.31 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.22 / $11.22 / $11.22
| Facility | | $11.22 | $11.22 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $16.98 / $51.29
| Facility | | $7.59 | $16.98 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.46 / $17.38
| Professional | | $4.68 | $6.46 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $60.26
| Facility | | $60.26 | $60.26 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $11.48 / $21.38
| Facility | | $8.13 | $11.48 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $9.77 / $16.22
| Professional | | $6.03 | $9.77 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $9.77
| Professional | | $8.71 | $8.71 | $9.77 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $11.48 / $28.18
| Facility | | $8.32 | $11.48 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.17 / $15.14
| Professional | | $4.68 | $6.17 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $11.48 / $13.80
| Facility | | $4.79 | $11.48 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $4.79 / $11.48
| Professional | | $4.79 | $4.79 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.03 / $7.94
| Professional | | $4.47 | $6.03 | $7.94 |