- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $14.45 / $56.23 / $851.14
| Facility | | $14.45 | $56.23 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $8.91 / $29.51
| Professional | | $3.39 | $8.91 | $29.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $6.46
| Facility | | $6.46 | $6.46 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $1.86 / $8.91
| Professional | | $1.51 | $1.86 | $8.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $10.00 / $16.60
| Professional | | $5.37 | $10.00 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $16.22 / $56.23
| Facility | | $5.37 | $16.22 | $56.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $3.02 / $7.76
| Professional | | $1.82 | $3.02 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $10.23 / $23.99
| Professional | | $4.27 | $10.23 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $6.46 / $6.46
| Facility | | $2.69 | $6.46 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $758.58 / $6,760.83 / $18,620.87
| Facility | | $758.58 | $6,760.83 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $9.33 / $21.38
| Facility | | $4.47 | $9.33 | $21.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $3.02 / $34.67
| Professional | | $1.82 | $3.02 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $9.12 / $9.12
| Professional | | $7.24 | $9.12 | $9.12 |