- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $18.20 / $28.84
| Facility | | $9.55 | $18.20 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.24 / $10.47
| Professional | | $6.03 | $7.24 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $9.55 / $24.55
| Facility | | $9.55 | $9.55 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.90 / $19.50
| Professional | | $4.07 | $4.90 | $19.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $9.55 / $9.55
| Facility | | $5.75 | $9.55 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $9.55 / $9.55
| Professional | | $6.92 | $9.55 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.33 / $19.95 / $89.13
| Facility | | $9.33 | $19.95 | $89.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $12.02 / $48.98
| Professional | | $5.75 | $12.02 | $48.98 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $10.96 / $26.30
| Facility | | $5.50 | $10.96 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.76 / $18.62
| Professional | | $4.47 | $6.76 | $18.62 |
- 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
- $6.03 / $8.13 / $10.72
| Professional | | $6.03 | $8.13 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $17.38 / $50,118.72
| Facility | | $8.13 | $17.38 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $11.48 / $13.49
| Facility | | $6.17 | $11.48 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.03 / $21.38
| Professional | | $3.98 | $6.03 | $21.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.13 / $15.85
| Facility | | $7.08 | $8.13 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $9.12 / $19.50
| Professional | | $6.31 | $9.12 | $19.50 |