- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $20.42 / $32.36
| Facility | | $8.13 | $20.42 | $32.36 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $7.94 / $16.22
| Professional | | $2.00 | $7.94 | $16.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $28.18
| Facility | | $10.72 | $10.72 | $28.18 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $4.27 / $15.49
| Professional | | $3.16 | $4.27 | $15.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $10.72 / $10.72
| Facility | | $6.46 | $10.72 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $10.72 / $10.72
| Professional | | $7.76 | $10.72 | $10.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.47 / $22.91 / $38.02
| Facility | | $10.47 | $22.91 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $13.18 / $51.29
| Professional | | $6.46 | $13.18 | $51.29 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $11.22 / $23.99
| Facility | | $5.50 | $11.22 | $23.99 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $7.59 / $20.89
| Professional | | $4.27 | $7.59 | $20.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $3.80 / $3.80
| Facility | | $3.80 | $3.80 | $3.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $9.12 / $12.88
| Professional | | $3.80 | $9.12 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $40.74 / $40.74
| Facility | | $40.74 | $40.74 | $40.74 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $19.50 / $50,118.72
| Facility | | $8.13 | $19.50 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $12.02 / $14.45
| Facility | | $6.46 | $12.02 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $6.46 / $23.99
| Professional | | $4.47 | $6.46 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.57 / $19.95
| Facility | | $3.80 | $4.57 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $10.23 / $26.92
| Professional | | $3.80 | $10.23 | $26.92 |