- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $18.62 / $31.62
| Facility | | $6.76 | $18.62 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $12.88
| Professional | | $3.98 | $5.01 | $12.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $34.67 / $46.77 / $5,011.87
| Facility | | $34.67 | $46.77 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $5.62 / $6.61
| Professional | | $5.62 | $5.62 | $6.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $10.72 / $24.55
| Facility | | $5.13 | $10.72 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $8.71 / $16.22
| Professional | | $3.80 | $8.71 | $16.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $4.27 / $10.47
| Professional | | $3.39 | $4.27 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.24 / $7.24
| Facility | | $7.24 | $7.24 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.41 / $12.59
| Professional | | $6.46 | $7.41 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $44.67 / $44.67 / $44.67
| Facility | | $44.67 | $44.67 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $6.46
| Professional | | $5.37 | $5.37 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.89 / $17.38 / $24.55
| Facility | | $5.89 | $17.38 | $24.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $7.94
| Professional | | $5.01 | $5.01 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $7.41 / $47.86
| Facility | | $7.24 | $7.41 | $47.86 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.24 / $9.12 / $47.86
| Professional | | $7.24 | $9.12 | $47.86 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $7.24 / $8.71
| Facility | | $3.89 | $7.24 | $8.71 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.57 / $11.48
| Professional | | $3.09 | $4.57 | $11.48 |