- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $25.12 / $97.72
| Facility | | $5.37 | $25.12 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.92 / $16.22
| Professional | | $4.47 | $6.92 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $5.37 / $5.37
| Professional | | $3.72 | $5.37 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $26.30 / $45.71
| Facility | | $10.23 | $26.30 | $45.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.01 / $7.76
| Professional | | $4.27 | $5.01 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $12.02 / $56.23
| Facility | | $7.08 | $12.02 | $56.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $7.59 / $7.76
| Facility | | $7.59 | $7.59 | $7.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $16.98 / $41.69
| Facility | | $8.91 | $16.98 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $5.62 / $13.18
| Professional | | $4.47 | $5.62 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $60.26 / $60.26 / $100.00
| Facility | | $60.26 | $60.26 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $15.14
| Professional | | $15.14 | $15.14 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.76 / $38.90
| Facility | | $5.75 | $7.76 | $38.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $6.92 / $14.13
| Professional | | $4.07 | $6.92 | $14.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.46 / $6.46
| Professional | | $5.75 | $6.46 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $7.76 / $22.39
| Facility | | $6.17 | $7.76 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $5.62 / $12.88
| Professional | | $4.47 | $5.62 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $7.76 / $9.33
| Facility | | $3.47 | $7.76 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.47 / $8.32
| Professional | | $3.24 | $4.47 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $7.76
| Professional | | $3.02 | $3.98 | $7.76 |