- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $16.22 / $26.30
| Facility | | $5.62 | $16.22 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $10.96
| Professional | | $3.98 | $5.01 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $31.62 / $41.69 / $5,011.87
| Facility | | $31.62 | $41.69 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $5.89
| Professional | | $4.68 | $4.68 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.37 / $9.12 / $19.95
| Facility | | $4.37 | $9.12 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $7.59 / $14.45
| Professional | | $3.55 | $7.59 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $3.55 / $8.71
| Professional | | $2.82 | $3.55 | $8.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $6.03
| Facility | | $6.03 | $6.03 | $6.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $6.76 / $10.47
| Professional | | $5.89 | $6.76 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $15.85 / $20.42
| Facility | | $4.90 | $15.85 | $20.42 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $7.08
| Professional | | $3.98 | $5.01 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $18.62 / $19.05
| Facility | | $6.03 | $18.62 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $9.77 / $19.05
| Professional | | $4.47 | $9.77 | $19.05 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $6.03 / $7.24
| Facility | | $3.55 | $6.03 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.47 / $10.47
| Professional | | $2.69 | $4.47 | $10.47 |