- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $24.55 / $40.74
| Facility | | $7.94 | $24.55 | $40.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.13 / $25.70
| Professional | | $3.98 | $5.13 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.95 / $2.95 / $9.33
| Professional | | $2.95 | $2.95 | $9.33 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $13.49 / $29.51
| Facility | | $2.69 | $13.49 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $5.13 / $15.14
| Professional | | $2.34 | $5.13 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $34.67 / $70.79
| Facility | | $11.48 | $34.67 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $4.90 / $15.14
| Professional | | $3.39 | $4.90 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $10.23 / $19.95
| Facility | | $4.47 | $10.23 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $7.94
| Professional | | $3.47 | $3.47 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $5.89 / $9.33
| Professional | | $4.68 | $5.89 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $5.89 / $11.48
| Professional | | $4.68 | $5.89 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $85.11 / $85.11
| Facility | | $85.11 | $85.11 | $85.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $8.71 / $8.71
| Professional | | $8.71 | $8.71 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.76 / $15.14
| Facility | | $4.47 | $6.76 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.47 / $5.89
| Professional | | $3.47 | $3.47 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $13.18
| Professional | | $13.18 | $13.18 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $5.25 / $7.94
| Professional | | $4.68 | $5.25 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $3.24 / $5.89
| Facility | | $2.63 | $3.24 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.17 / $11.48
| Professional | | $3.47 | $4.17 | $11.48 |