- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $69.18 / $147.91
| Facility | | $5.62 | $69.18 | $147.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $2.69 / $5.13
| Professional | | $1.78 | $2.69 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.78 / $3.02
| Professional | | $1.35 | $1.78 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.11 / $87.10 / $169.82
| Facility | | $33.11 | $87.10 | $169.82 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $1.70 / $5.50
| Professional | | $1.62 | $1.70 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $4.90 / $162.18
| Facility | | $2.75 | $4.90 | $162.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $3.16 / $6.17
| Professional | | $2.09 | $3.16 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $18.62 / $18.62
| Facility | | $3.02 | $18.62 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $6.46 / $16.22
| Facility | | $3.39 | $6.46 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $2.19 / $5.89
| Professional | | $1.66 | $2.19 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $89.13 / $89.13 / $89.13
| Facility | | $89.13 | $89.13 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $3.72 / $11.48
| Professional | | $2.45 | $3.72 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $45.71 / $144.54
| Facility | | $2.69 | $45.71 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.58 / $2.69 / $5.37
| Professional | | $1.58 | $2.69 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $2.51 / $2.51
| Professional | | $2.24 | $2.51 | $2.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,380.38 / $3,311.31 / $3,311.31
| Facility | | $1,380.38 | $3,311.31 | $3,311.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $3.02 / $10.96
| Facility | | $2.40 | $3.02 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.66 / $2.19 / $4.79
| Professional | | $1.66 | $2.19 | $4.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $3.02 / $30.20
| Facility | | $1.51 | $3.02 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.74 / $4.17
| Professional | | $1.26 | $1.74 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.17 / $1.55 / $3.02
| Professional | | $1.17 | $1.55 | $3.02 |