- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $30.20 / $93.33
| Facility | | $8.32 | $30.20 | $93.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.03 / $41.69
| Professional | | $3.98 | $6.03 | $41.69 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $3.55 / $4.27
| Professional | | $3.55 | $3.55 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,047.13 / $1,047.13 / $1,047.13
| Facility | | $1,047.13 | $1,047.13 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $37.15 / $48.98 / $5,011.87
| Facility | | $37.15 | $48.98 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.50 / $23.44
| Professional | | $5.50 | $5.50 | $23.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $10.72 / $23.44
| Facility | | $5.01 | $10.72 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $8.91 / $14.79
| Professional | | $4.17 | $8.91 | $14.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $6.17 / $10.23
| Professional | | $3.31 | $6.17 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $7.08 / $7.08
| Facility | | $7.08 | $7.08 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $7.76 / $12.02
| Professional | | $6.92 | $7.76 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $16.60 / $51.29
| Facility | | $9.55 | $16.60 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.68 / $5.89
| Professional | | $4.17 | $4.68 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $30.20 / $363.08
| Facility | | $13.18 | $30.20 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $10.47 / $25.70
| Facility | | $4.90 | $10.47 | $25.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.62 / $11.22
| Professional | | $3.98 | $5.62 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $10.47 / $25.12
| Facility | | $10.47 | $10.47 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $23.99 / $25.12
| Professional | | $10.47 | $23.99 | $25.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $7.08 / $8.32
| Facility | | $4.07 | $7.08 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $4.57 / $12.30
| Professional | | $3.16 | $4.57 | $12.30 |