- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $53.70 / $141.25
| Facility | | $9.77 | $53.70 | $141.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.24 / $54.95
| Professional | | $6.03 | $7.24 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.90 / $12.59
| Professional | | $4.07 | $4.90 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $8.51 / $14.79
| Facility | | $7.41 | $8.51 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.79 / $6.92
| Professional | | $3.80 | $4.79 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $5.50
| Facility | | $5.50 | $5.50 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $6.46
| Professional | | $6.46 | $6.46 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $8.51 / $10.00
| Facility | | $8.13 | $8.51 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $8.13 / $10.96
| Professional | | $5.25 | $8.13 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $10.47 / $52.48
| Facility | | $5.37 | $10.47 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $7.59 / $15.49
| Professional | | $4.17 | $7.59 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $40.74 / $87.10
| Facility | | $13.18 | $40.74 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $6.46 / $15.14
| Professional | | $3.16 | $6.46 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.24 / $10.00
| Professional | | $6.03 | $7.24 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $9.77 / $17.78
| Facility | | $9.77 | $9.77 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $8.91 / $17.78
| Professional | | $5.62 | $8.91 | $17.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.13 / $12.02
| Facility | | $4.07 | $8.13 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $4.90 / $11.22
| Professional | | $3.39 | $4.90 | $11.22 |