- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $22.91 / $85.11
| Facility | | $8.71 | $22.91 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $7.94 / $60.26
| Professional | | $3.98 | $7.94 | $60.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $24.55 / $52.48
| Facility | | $5.50 | $24.55 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $6.92 / $20.89
| Professional | | $2.75 | $6.92 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $19.95 / $56.23 / $120.23
| Facility | | $19.95 | $56.23 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.98 / $24.55
| Professional | | $2.69 | $3.98 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $18.62 / $38.02
| Facility | | $7.94 | $18.62 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $11.48 / $23.99
| Professional | | $5.75 | $11.48 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $10.47 / $16.98
| Professional | | $5.89 | $10.47 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $10.47 / $23.44
| Professional | | $8.32 | $10.47 | $23.44 |
- 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
- $5.25 / $5.25 / $10.47
| Professional | | $5.25 | $5.25 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $11.75 / $27.54
| Facility | | $5.13 | $11.75 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $9.55 / $23.99
| Professional | | $5.75 | $9.55 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $37.15 / $37.15
| Professional | | $37.15 | $37.15 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $8.32 / $10.47
| Professional | | $5.89 | $8.32 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $7.08 / $10.47
| Facility | | $4.68 | $7.08 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $6.31 / $20.42
| Professional | | $4.37 | $6.31 | $20.42 |