- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $17.78 / $61.66
| Facility | | $5.13 | $17.78 | $61.66 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.63 / $16.98
| Professional | | $3.02 | $3.63 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.40 / $79.43
| Professional | | $1.95 | $2.40 | $79.43 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $4.90 / $380.19
| Facility | | $2.00 | $4.90 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.51 / $2.82
| Professional | | $2.51 | $2.51 | $2.82 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.89 / $27.54 / $5,011.87
| Facility | | $20.89 | $27.54 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $3.09 / $12.30
| Professional | | $3.09 | $3.09 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $6.03 / $13.49
| Facility | | $2.82 | $6.03 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $4.57 / $7.08
| Professional | | $2.29 | $4.57 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $3.89 / $5.75
| Professional | | $1.86 | $3.89 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $3.89 / $3.89
| Facility | | $3.89 | $3.89 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.37 / $6.76
| Professional | | $3.80 | $4.37 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $9.77 / $21.88
| Facility | | $5.37 | $9.77 | $21.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.57 / $3.47
| Professional | | $2.34 | $2.57 | $3.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $4.90 / $10.47
| Facility | | $3.24 | $4.90 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $2.51 / $2.51
| Professional | | $2.19 | $2.51 | $2.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.75 / $5.89 / $12.59
| Facility | | $2.75 | $5.89 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.09 / $3.39 / $6.46
| Professional | | $2.09 | $3.39 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,445.44 / $1,479.11 / $1,995.26
| Facility | | $1,445.44 | $1,479.11 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $5.37
| Facility | | $5.37 | $5.37 | $5.37 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $5.37 / $8.13
| Professional | | $4.17 | $5.37 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.29 / $3.89 / $4.68
| Facility | | $2.29 | $3.89 | $4.68 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $3.89 / $6.61
| Professional | | $2.34 | $3.89 | $6.61 |