- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $10.72 / $165.96
| Facility | | $4.79 | $10.72 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $12.30
| Professional | | $3.02 | $3.98 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $3.16 / $3.16
| Professional | | $3.16 | $3.16 | $3.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.50 / $9.55
| Facility | | $4.79 | $5.50 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.24 / $6.76
| Professional | | $2.57 | $3.24 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $3.55 / $3.55
| Facility | | $3.55 | $3.55 | $3.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $3.55 / $6.03
| Facility | | $3.55 | $3.55 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $6.92
| Professional | | $6.92 | $6.92 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $6.76 / $33.11
| Facility | | $3.39 | $6.76 | $33.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.47 / $10.00
| Professional | | $2.63 | $3.47 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $6.76 / $128.82
| Facility | | $3.39 | $6.76 | $128.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $4.07 / $8.71
| Professional | | $2.63 | $4.07 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.68 / $6.46
| Professional | | $3.89 | $4.68 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $154.88 / $208.93 / $426.58
| Facility | | $154.88 | $208.93 | $426.58 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $5.50 / $10.47
| Professional | | $3.63 | $5.50 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $39.81 / $389.05
| Facility | | $3.39 | $39.81 | $389.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.09 / $6.31
| Professional | | $2.19 | $3.09 | $6.31 |