- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $27.54 / $79.43
| Facility | | $4.27 | $27.54 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.62 / $35.48
| Professional | | $3.98 | $5.62 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.39 / $6.92
| Professional | | $2.82 | $3.39 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $13.18 / $28.18
| Facility | | $3.24 | $13.18 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $5.01 / $16.22
| Professional | | $2.82 | $5.01 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $45.71 / $91.20
| Facility | | $13.18 | $45.71 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.46 / $18.62
| Professional | | $4.47 | $6.46 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $10.00 / $20.89
| Facility | | $4.37 | $10.00 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $6.61 / $14.45
| Professional | | $3.31 | $6.61 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.62 / $9.12
| Professional | | $5.01 | $5.62 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.62 / $12.88
| Professional | | $4.57 | $5.62 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $60.26
| Facility | | $60.26 | $60.26 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $6.61 / $11.22
| Professional | | $4.90 | $6.61 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $3.39 / $6.76
| Professional | | $3.39 | $3.39 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.76 / $18.62
| Facility | | $4.68 | $6.76 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $5.25 / $14.45
| Professional | | $3.31 | $5.25 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $19.95 / $19.95
| Professional | | $19.95 | $19.95 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.75 / $9.55
| Professional | | $4.57 | $5.75 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.89 / $5.62
| Facility | | $2.51 | $3.89 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $3.39 / $12.02
| Professional | | $2.40 | $3.39 | $12.02 |