- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $25.70 / $56.23
| Facility | | $7.41 | $25.70 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $16.22 / $32.36
| Professional | | $4.17 | $16.22 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $7.94
| Professional | | $7.94 | $7.94 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $11.75 / $25.12
| Facility | | $3.31 | $11.75 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $6.17 / $15.14
| Professional | | $2.82 | $6.17 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $42.66 / $87.10
| Facility | | $11.48 | $42.66 | $87.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.75 / $16.22
| Professional | | $3.98 | $5.75 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $8.91 / $18.20
| Facility | | $3.80 | $8.91 | $18.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $6.76 / $21.38
| Professional | | $3.16 | $6.76 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $5.01 / $7.94
| Professional | | $4.27 | $5.01 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $12.02
| Professional | | $3.98 | $5.01 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $79.43 / $79.43 / $79.43
| Facility | | $79.43 | $79.43 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $6.03
| Professional | | $3.02 | $3.02 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $6.03 / $14.79
| Facility | | $2.63 | $6.03 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $6.03 / $20.89
| Professional | | $3.16 | $6.03 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $17.78 / $17.78
| Professional | | $17.78 | $17.78 | $17.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.79 / $7.24
| Professional | | $3.98 | $4.79 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.47 / $5.01
| Facility | | $2.24 | $3.47 | $5.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.47 / $11.75
| Professional | | $3.02 | $4.47 | $11.75 |