- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $37.15 / $120.23
| Facility | | $4.27 | $37.15 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.69 / $4.47
| Professional | | $2.00 | $2.69 | $4.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $1.78 / $2.09
| Professional | | $1.51 | $1.78 | $2.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $107.15 / $218.78
| Facility | | $66.07 | $107.15 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $2.69 / $3.02
| Professional | | $2.24 | $2.69 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $6.61 / $10.72
| Facility | | $3.09 | $6.61 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $3.09 / $5.50
| Professional | | $1.82 | $3.09 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $2.63 / $3.16
| Professional | | $1.91 | $2.63 | $3.16 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $5.89
| Facility | | $3.02 | $3.02 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.79 / $10.00
| Facility | | $2.69 | $4.79 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $3.63
| Professional | | $2.69 | $2.69 | $3.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $28.18 / $107.15 / $218.78
| Facility | | $28.18 | $107.15 | $218.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $2.69 / $3.02
| Professional | | $2.24 | $2.69 | $3.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $125.89 / $213.80
| Facility | | $3.02 | $125.89 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.26 / $1.74 / $5.75
| Professional | | $1.26 | $1.74 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.35 / $1.55 / $5.37
| Professional | | $1.35 | $1.55 | $5.37 |