- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $21.38 / $63.10
| Facility | | $6.03 | $21.38 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $6.03 / $15.14
| Professional | | $3.89 | $6.03 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $7.76 / $562.34
| Facility | | $2.82 | $7.76 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $12.30 / $5,011.87
| Facility | | $9.33 | $12.30 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $6.03 / $6.03
| Professional | | $5.50 | $6.03 | $6.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $10.72 / $26.92
| Facility | | $5.25 | $10.72 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $8.51 / $12.59
| Professional | | $3.16 | $8.51 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $5.13 / $11.22
| Professional | | $3.63 | $5.13 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $7.76
| Facility | | $7.76 | $7.76 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.82 / $5.50 / $13.49
| Professional | | $1.82 | $5.50 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $14.79 / $43.65
| Facility | | $9.33 | $14.79 | $43.65 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $5.89 / $5.89
| Professional | | $5.89 | $5.89 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $7.41 / $309.03
| Facility | | $2.82 | $7.41 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $8.71 / $26.30
| Facility | | $4.68 | $8.71 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $6.03 / $8.91
| Professional | | $3.89 | $6.03 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.43 / $0.43
| Facility | | $0.43 | $0.43 | $0.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $0.43 / $0.43 / $2.95
| Professional | | $0.43 | $0.43 | $2.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $7.76 / $9.33
| Facility | | $3.47 | $7.76 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $4.68 / $9.77
| Professional | | $2.34 | $4.68 | $9.77 |