- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $25.12 / $57.54
| Facility | | $6.61 | $25.12 | $57.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $27.54
| Professional | | $3.02 | $3.98 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $2.57 / $2.82
| Professional | | $2.57 | $2.57 | $2.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $10.00 / $21.38
| Facility | | $2.45 | $10.00 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $5.25 / $12.02
| Professional | | $2.09 | $5.25 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $34.67 / $70.79
| Facility | | $9.77 | $34.67 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $4.90 / $13.80
| Professional | | $3.39 | $4.90 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $7.59 / $15.85
| Facility | | $3.24 | $7.59 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $5.01 / $10.96
| Professional | | $2.51 | $5.01 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.27 / $6.76
| Professional | | $3.80 | $4.27 | $6.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $4.27 / $9.77
| Professional | | $3.39 | $4.27 | $9.77 |
- 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
- $2.57 / $2.57 / $5.13
| Professional | | $2.57 | $2.57 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $5.13 / $13.49
| Facility | | $3.55 | $5.13 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $3.89 / $10.96
| Professional | | $2.51 | $3.89 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $15.14 / $15.14 / $15.14
| Professional | | $15.14 | $15.14 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $4.27 / $6.46
| Professional | | $3.39 | $4.27 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.91 / $2.95 / $4.27
| Facility | | $1.91 | $2.95 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $3.63 / $8.71
| Professional | | $2.57 | $3.63 | $8.71 |