- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $34.67 / $104.71
| Facility | | $6.61 | $34.67 | $104.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.08 / $10.72
| Professional | | $5.01 | $7.08 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.47 / $6.17
| Professional | | $4.27 | $4.47 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $28.84 / $53.70
| Facility | | $9.77 | $28.84 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $5.25 / $8.91
| Professional | | $4.90 | $5.25 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $13.80 / $64.57
| Facility | | $8.13 | $13.80 | $64.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $8.71 / $14.13
| Professional | | $6.17 | $8.71 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $12.59 / $12.59
| Facility | | $8.91 | $12.59 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $19.50 / $47.86
| Facility | | $10.23 | $19.50 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.92 / $14.79
| Professional | | $5.01 | $6.92 | $14.79 |
- 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
- $17.78 / $17.78 / $17.78
| Professional | | $17.78 | $17.78 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $8.91 / $77.62
| Facility | | $6.76 | $8.91 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.94 / $14.13
| Professional | | $5.01 | $7.94 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $7.41 / $7.41
| Professional | | $6.61 | $7.41 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $26.30
| Facility | | $7.08 | $8.91 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.76 / $14.79
| Professional | | $5.01 | $6.76 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $8.91 / $10.72
| Facility | | $3.98 | $8.91 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $5.25 / $8.71
| Professional | | $3.72 | $5.25 | $8.71 |