- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $46.77 / $131.83
| Facility | | $5.62 | $46.77 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.72 / $5.13
| Professional | | $3.02 | $3.72 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $2.14 / $2.95
| Professional | | $1.91 | $2.14 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $13.18 / $25.12
| Facility | | $4.68 | $13.18 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.57 / $5.50
| Professional | | $2.34 | $2.57 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $6.31 / $77.62
| Facility | | $3.24 | $6.31 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.27 / $6.76
| Professional | | $3.24 | $4.27 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $6.03 / $6.03
| Facility | | $4.27 | $6.03 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $9.33 / $23.44
| Facility | | $4.90 | $9.33 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $3.09 / $8.32
| Professional | | $2.40 | $3.09 | $8.32 |
- 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
- $3.55 / $5.50 / $8.51
| Professional | | $3.55 | $5.50 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $14.45 / $112.20
| Facility | | $3.24 | $14.45 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.72 / $7.41
| Professional | | $2.24 | $3.72 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.63 / $3.63
| Professional | | $3.24 | $3.63 | $3.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $512.86 / $512.86
| Facility | | $218.78 | $512.86 | $512.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $4.27 / $12.59
| Facility | | $3.39 | $4.27 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $3.09 / $7.08
| Professional | | $2.40 | $3.09 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $4.27 / $5.13
| Facility | | $1.91 | $4.27 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $2.45 / $4.47
| Professional | | $1.78 | $2.45 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $2.19 / $4.27
| Professional | | $1.66 | $2.19 | $4.27 |