- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $50.12 / $109.65
| Facility | | $14.45 | $50.12 | $109.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $10.96 / $67.61
| Professional | | $7.08 | $10.96 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.31 / $16.60
| Professional | | $5.13 | $6.31 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $23.99 / $51.29
| Facility | | $5.89 | $23.99 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $9.12 / $28.18
| Professional | | $5.13 | $9.12 | $28.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $23.99 / $74.13 / $165.96
| Facility | | $23.99 | $74.13 | $165.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $11.75 / $33.88
| Professional | | $8.32 | $11.75 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $18.20 / $38.02
| Facility | | $7.76 | $18.20 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $12.02 / $25.70
| Professional | | $6.17 | $12.02 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $10.23 / $16.60
| Professional | | $9.12 | $10.23 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.23 / $23.44
| Professional | | $8.32 | $10.23 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $77.62 / $77.62
| Facility | | $77.62 | $77.62 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $12.30
| Professional | | $6.17 | $6.17 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $12.30 / $29.51
| Facility | | $8.51 | $12.30 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $9.55 / $25.70
| Professional | | $6.17 | $9.55 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $36.31 / $36.31 / $36.31
| Professional | | $36.31 | $36.31 | $36.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.23 / $15.49
| Professional | | $8.32 | $10.23 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $7.08 / $10.23
| Facility | | $4.68 | $7.08 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.17 / $21.38
| Professional | | $4.37 | $6.17 | $21.38 |