- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $6.61 / $223.87
| Facility | | $3.02 | $6.61 | $223.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $3.09 / $10.47
| Professional | | $2.00 | $3.09 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.09 / $4.07
| Facility | | $2.82 | $3.09 | $4.07 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $2.69 / $16.98
| Professional | | $2.57 | $2.69 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.55 / $4.79
| Facility | | $3.47 | $3.55 | $4.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.47 / $6.46
| Professional | | $2.82 | $3.47 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $4.57 / $6.17
| Facility | | $3.16 | $4.57 | $6.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $3.31
| Professional | | $2.69 | $2.69 | $3.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $4.47 / $8.71
| Professional | | $2.82 | $4.47 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $2.82 / $5.89
| Professional | | $2.29 | $2.82 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $40.74
| Professional | | $40.74 | $40.74 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $3.39 / $3.39
| Professional | | $3.39 | $3.39 | $3.39 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $70.79
| Professional | | $54.95 | $54.95 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $2.82 / $4.90
| Facility | | $2.29 | $2.82 | $4.90 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $2.69 / $4.17
| Professional | | $2.69 | $2.69 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.17 / $4.17
| Professional | | $4.17 | $4.17 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.14 / $2.95 / $4.57
| Professional | | $2.14 | $2.95 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $7.94
| Facility | | $7.94 | $7.94 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $2.75 / $3.63
| Professional | | $2.57 | $2.75 | $3.63 |