- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $44.67 / $123.03
| Facility | | $11.48 | $44.67 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.94 / $41.69
| Professional | | $5.01 | $7.94 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.57 / $6.03
| Professional | | $3.47 | $4.57 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $17.38 / $37.15
| Facility | | $3.98 | $17.38 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $6.03 / $21.38
| Professional | | $3.39 | $6.03 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $16.98 / $53.70 / $109.65
| Facility | | $16.98 | $53.70 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $7.76 / $22.39
| Professional | | $5.50 | $7.76 | $22.39 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $13.18 / $26.92
| Facility | | $5.75 | $13.18 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.13 / $15.49
| Professional | | $4.07 | $8.13 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $7.41 / $12.02
| Professional | | $4.27 | $7.41 | $12.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.41 / $16.98
| Professional | | $6.03 | $7.41 | $16.98 |
- 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
- $4.47 / $4.47 / $8.91
| Professional | | $4.47 | $4.47 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $8.91 / $22.39
| Facility | | $6.03 | $8.91 | $22.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $6.76 / $17.38
| Professional | | $4.07 | $6.76 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $26.30 / $26.30 / $26.30
| Professional | | $26.30 | $26.30 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.59 / $12.59
| Professional | | $6.03 | $7.59 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $5.13 / $7.41
| Facility | | $3.39 | $5.13 | $7.41 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $4.47 / $14.45
| Professional | | $3.16 | $4.47 | $14.45 |