- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $20.42 / $34.67
| Facility | | $10.72 | $20.42 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $8.91 / $20.42
| Professional | | $7.08 | $8.91 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $27.54
| Facility | | $10.72 | $10.72 | $27.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $5.50 / $24.55
| Professional | | $5.13 | $5.50 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $10.72 / $10.72
| Facility | | $6.31 | $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 / $26.92 / $112.20
| Facility | | $10.47 | $26.92 | $112.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.08 / $15.49 / $67.61
| Professional | | $7.08 | $15.49 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $13.80 / $34.67
| Facility | | $8.51 | $13.80 | $34.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.41 / $20.42
| Professional | | $5.01 | $7.41 | $20.42 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $10.72 / $10.72
| Facility | | $10.72 | $10.72 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $10.72 / $13.80
| Professional | | $9.12 | $10.72 | $13.80 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $20.42 / $104.71 / $104.71
| Facility | | $20.42 | $104.71 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.88 / $19.95 / $50,118.72
| Facility | | $12.88 | $19.95 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $12.88 / $16.98
| Facility | | $7.76 | $12.88 | $16.98 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $8.51 / $23.99
| Professional | | $4.47 | $8.51 | $23.99 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $10.72 / $25.12
| Facility | | $9.12 | $10.72 | $25.12 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $11.22 / $31.62
| Professional | | $9.12 | $11.22 | $31.62 |