- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.13 / $25.70
| Facility | | $6.03 | $8.13 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $9.55
| Professional | | $5.01 | $6.03 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.22 / $17.38 / $24.55
| Facility | | $16.22 | $17.38 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $6.76 / $10.23
| Professional | | $5.75 | $6.76 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $16.22 / $35.48
| Facility | | $5.25 | $16.22 | $35.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $4.07 / $11.48
| Professional | | $3.31 | $4.07 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $7.24 / $9.12
| Professional | | $4.37 | $7.24 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $6.92 / $12.88
| Facility | | $3.89 | $6.92 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.92 / $6.92
| Professional | | $5.01 | $6.92 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $8.13
| Professional | | $7.76 | $7.76 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $7.76 / $9.33
| Facility | | $3.89 | $7.76 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.89 / $9.55
| Professional | | $3.24 | $3.89 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $70.79 / $70.79 / $70.79
| Facility | | $70.79 | $70.79 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $57.54
| Professional | | $40.74 | $40.74 | $57.54 |