- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $32.36 / $173.78
| Facility | | $5.89 | $32.36 | $173.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $51.29
| Professional | | $3.98 | $5.01 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.72 / $3.72
| Professional | | $3.24 | $3.72 | $3.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $5.75 / $10.00
| Facility | | $4.90 | $5.75 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.31 / $7.08
| Professional | | $2.63 | $3.31 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $3.63 / $3.63
| Facility | | $3.63 | $3.63 | $3.63 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $4.27
| Professional | | $4.27 | $4.27 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.62 / $6.76
| Facility | | $4.07 | $5.62 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $5.37 / $7.24
| Professional | | $3.47 | $5.37 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $7.08 / $34.67
| Facility | | $3.63 | $7.08 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.55 / $10.23
| Professional | | $2.82 | $3.55 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $24.55 / $109.65
| Facility | | $3.47 | $24.55 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $4.17 / $8.91
| Professional | | $2.95 | $4.17 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.79 / $6.61
| Professional | | $4.07 | $4.79 | $6.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $6.46
| Facility | | $6.46 | $6.46 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $5.62 / $10.96
| Professional | | $3.80 | $5.62 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $5.37 / $8.13
| Facility | | $2.69 | $5.37 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.24 / $7.08
| Professional | | $2.24 | $3.24 | $7.08 |