- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $44.67 / $151.36
| Facility | | $9.33 | $44.67 | $151.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.03 / $33.11
| Professional | | $3.98 | $6.03 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $3.16 / $6.31
| Professional | | $2.40 | $3.16 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $12.02 / $25.70
| Facility | | $4.47 | $12.02 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $4.57 / $16.60
| Professional | | $2.57 | $4.57 | $16.60 |
- 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
- $4.07 / $5.89 / $16.98
| Professional | | $4.07 | $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 / $11.75
| Professional | | $3.09 | $5.75 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.13 / $8.32
| Professional | | $4.57 | $5.13 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.13 / $11.75
| Professional | | $4.17 | $5.13 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $100.00
| Facility | | $60.26 | $60.26 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $7.08 / $19.50
| Professional | | $4.37 | $7.08 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $6.17
| Professional | | $6.17 | $6.17 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $6.17 / $16.60
| Facility | | $4.27 | $6.17 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.90 / $12.88
| Professional | | $3.09 | $4.90 | $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 / $5.25 / $8.71
| Professional | | $4.17 | $5.25 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.55 / $5.13
| Facility | | $2.19 | $3.55 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.16 / $22.39
| Professional | | $2.19 | $3.16 | $22.39 |