- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $57.54 / $489.78
| Facility | | $8.51 | $57.54 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.92 / $67.61
| Professional | | $6.03 | $6.92 | $67.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $5.25 / $11.48
| Professional | | $3.39 | $5.25 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $8.91 / $15.49
| Facility | | $7.76 | $8.91 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $4.68 / $7.08
| Professional | | $3.47 | $4.68 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $11.75
| Facility | | $5.75 | $5.75 | $11.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $6.76 / $6.76
| Professional | | $5.89 | $6.76 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.91 / $10.47
| Facility | | $8.51 | $8.91 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $8.51 / $11.48
| Professional | | $5.50 | $8.51 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $10.23 / $34.67
| Facility | | $5.62 | $10.23 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $7.94 / $16.22
| Professional | | $4.27 | $7.94 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $17.78 / $50.12 / $123.03
| Facility | | $17.78 | $50.12 | $123.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $8.13 / $22.91
| Professional | | $3.39 | $8.13 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $7.59 / $10.47
| Professional | | $6.31 | $7.59 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.23 / $10.23 / $13.80
| Facility | | $10.23 | $10.23 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $9.33 / $16.98
| Professional | | $6.31 | $9.33 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $8.51 / $12.59
| Facility | | $3.16 | $8.51 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $5.13 / $37.15
| Professional | | $3.55 | $5.13 | $37.15 |