- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $25.70 / $131.83
| Facility | | $5.89 | $25.70 | $131.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $14.13
| Professional | | $3.98 | $5.01 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $6.17 / $10.72
| Facility | | $5.37 | $6.17 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $3.63 / $7.59
| Professional | | $2.88 | $3.63 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.17 / $7.41
| Facility | | $4.47 | $6.17 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $5.89 / $7.94
| Professional | | $3.80 | $5.89 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $7.59 / $38.02
| Facility | | $3.89 | $7.59 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $3.80 / $11.22
| Professional | | $2.95 | $3.80 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $15.85 / $60.26
| Facility | | $3.80 | $15.85 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $3.80 / $9.55
| Professional | | $2.95 | $3.80 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $5.25 / $7.24
| Professional | | $4.37 | $5.25 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $7.08
| Facility | | $7.08 | $7.08 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $6.17 / $12.02
| Professional | | $4.07 | $6.17 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $5.89 / $8.91
| Facility | | $2.95 | $5.89 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $3.55 / $8.13
| Professional | | $2.45 | $3.55 | $8.13 |