- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $21.88 / $72.44
| Facility | | $5.50 | $21.88 | $72.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $5.37 / $18.20
| Professional | | $2.00 | $5.37 | $18.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $3.72 / $60.26
| Facility | | $2.40 | $3.72 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $3.31 / $7.94
| Professional | | $1.62 | $3.31 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $6.46 / $9.33
| Facility | | $5.13 | $6.46 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.09 / $3.09
| Professional | | $3.02 | $3.09 | $3.09 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $4.27 / $9.12
| Facility | | $2.24 | $4.27 | $9.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $3.63 / $5.62
| Professional | | $1.78 | $3.63 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $15.85 / $7,079.46
| Facility | | $2.69 | $15.85 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $5.50
| Professional | | $4.68 | $4.68 | $5.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $7.41
| Professional | | $3.31 | $3.31 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $10.72 / $83.18
| Facility | | $3.98 | $10.72 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $3.72 / $60.26
| Facility | | $2.40 | $3.72 | $60.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.62 / $3.31 / $7.94
| Professional | | $1.62 | $3.31 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.40 / $3.80 / $7.24
| Facility | | $2.40 | $3.80 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $2.95 / $3.89
| Facility | | $1.48 | $2.95 | $3.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.48 / $3.31 / $7.59
| Professional | | $1.48 | $3.31 | $7.59 |