- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $13.49 / $19.50
| Facility | | $3.02 | $13.49 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.98 / $15.85
| Professional | | $3.02 | $3.98 | $15.85 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.92 / $70.79
| Facility | | $4.47 | $6.92 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $6.03 / $16.98
| Professional | | $3.24 | $6.03 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.77 / $12.30 / $17.38
| Facility | | $9.77 | $12.30 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $5.62 / $5.62
| Professional | | $4.79 | $5.62 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $7.41 / $14.45
| Facility | | $3.89 | $7.41 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.88 / $6.31 / $15.49
| Professional | | $2.88 | $6.31 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $8.13 / $4,897.79
| Facility | | $5.50 | $8.13 | $4,897.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $7.76 / $10.47
| Professional | | $6.61 | $7.76 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $13.18
| Professional | | $6.03 | $6.03 | $13.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.92 / $70.79
| Facility | | $4.47 | $6.92 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $6.03 / $16.98
| Professional | | $3.24 | $6.03 | $16.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $5.37 / $6.31
| Facility | | $2.57 | $5.37 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $6.03 / $17.78
| Professional | | $3.16 | $6.03 | $17.78 |