- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $12.30 / $26.92
| Facility | | $5.62 | $12.30 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.47 / $8.91
| Professional | | $3.02 | $3.47 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $24.55 / $32.36 / $5,011.87
| Facility | | $24.55 | $32.36 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $3.63 / $4.57
| Professional | | $3.63 | $3.63 | $4.57 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $7.08 / $15.49
| Facility | | $3.31 | $7.08 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $5.75 / $11.22
| Professional | | $2.75 | $5.75 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $2.75 / $6.76
| Professional | | $2.19 | $2.75 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $4.68
| Facility | | $4.68 | $4.68 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $5.13 / $8.13
| Professional | | $4.57 | $5.13 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $12.30 / $31.62
| Facility | | $6.31 | $12.30 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $3.47 / $4.47
| Professional | | $2.75 | $3.47 | $4.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $11.75 / $15.85
| Facility | | $3.80 | $11.75 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $6.92
| Professional | | $3.02 | $3.02 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $4.68
| Facility | | $3.02 | $3.02 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $5.75
| Professional | | $3.02 | $3.02 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.68 / $5.62
| Facility | | $2.69 | $4.68 | $5.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $3.47 / $8.13
| Professional | | $2.09 | $3.47 | $8.13 |