- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $17.38 / $37.15
| Facility | | $5.25 | $17.38 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $7.08
| Professional | | $3.02 | $3.02 | $7.08 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $20.89 / $436.52
| Facility | | $7.76 | $20.89 | $436.52 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.91 / $30.20 / $5,011.87
| Facility | | $22.91 | $30.20 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $3.39 / $4.27
| Professional | | $3.39 | $3.39 | $4.27 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $6.46 / $14.45
| Facility | | $3.09 | $6.46 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $5.50 / $10.72
| Professional | | $2.45 | $5.50 | $10.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.45 / $2.51 / $6.31
| Professional | | $1.45 | $2.51 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $4.27 / $4.27
| Facility | | $4.27 | $4.27 | $4.27 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.79 / $7.41
| Professional | | $4.17 | $4.79 | $7.41 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $16.22 / $33.88
| Facility | | $8.91 | $16.22 | $33.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $17.78 / $208.93
| Facility | | $7.76 | $17.78 | $208.93 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $7.41 / $12.59
| Facility | | $3.02 | $7.41 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $5.01
| Professional | | $3.02 | $3.02 | $5.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $5.62 / $11.22
| Facility | | $2.69 | $5.62 | $11.22 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $5.62 / $11.22
| Professional | | $2.69 | $5.62 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $4.27 / $5.13
| Facility | | $2.51 | $4.27 | $5.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $3.16 / $7.59
| Professional | | $1.95 | $3.16 | $7.59 |