- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $20.42 / $34.67
| Facility | | $7.41 | $20.42 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $14.13
| Professional | | $5.01 | $6.03 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $40.74 / $5,011.87
| Facility | | $30.20 | $40.74 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $6.31 / $6.31
| Professional | | $6.31 | $6.31 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $11.75 / $26.92
| Facility | | $5.50 | $11.75 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $9.12 / $14.45
| Professional | | $3.63 | $9.12 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $4.68 / $11.48
| Professional | | $3.80 | $4.68 | $11.48 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $7.94 / $7.94
| Facility | | $7.94 | $7.94 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.59 / $13.80
| Professional | | $6.03 | $7.59 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $15.14 / $27.54
| Facility | | $6.03 | $15.14 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $8.91
| Professional | | $5.01 | $6.03 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.94 / $8.51
| Facility | | $5.75 | $7.94 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $7.94 / $8.51
| Professional | | $5.75 | $7.94 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $7.94 / $9.55
| Facility | | $3.98 | $7.94 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $4.79 / $12.02
| Professional | | $3.39 | $4.79 | $12.02 |