- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $57.54 / $912.01
| Facility | | $9.12 | $57.54 | $912.01 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $8.91 / $33.11
| Professional | | $3.89 | $8.91 | $33.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.47 / $1,288.25
| Facility | | $2.24 | $3.47 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $7.59 / $21.38
| Professional | | $1.82 | $7.59 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.75 / $8.32
| Facility | | $4.57 | $5.75 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $2.82 / $4.57
| Professional | | $2.82 | $2.82 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $4.17 / $8.51
| Facility | | $1.95 | $4.17 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.51 / $4.27 / $12.88
| Professional | | $1.51 | $4.27 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $16.60 / $7,079.46
| Facility | | $2.40 | $16.60 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $13.18 / $15.49
| Professional | | $13.18 | $13.18 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $9.33 / $18.62
| Professional | | $7.94 | $9.33 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $5.89 / $26.92
| Facility | | $3.02 | $5.89 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $3.47 / $1,288.25
| Facility | | $2.24 | $3.47 | $1,288.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $7.59 / $21.38
| Professional | | $1.82 | $7.59 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $7.59 / $13.18
| Facility | | $2.29 | $7.59 | $13.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $7.59 / $13.49
| Professional | | $2.24 | $7.59 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.63 / $10.72
| Facility | | $2.69 | $3.63 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $3.47 / $11.22
| Professional | | $1.82 | $3.47 | $11.22 |