- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $14.45 / $37.15
| Facility | | $5.75 | $14.45 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.07 / $11.22
| Professional | | $3.02 | $4.07 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $6.31 / $79.43
| Facility | | $4.07 | $6.31 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.47 / $10.96
| Professional | | $2.69 | $4.47 | $10.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.72 / $15.49
| Facility | | $8.51 | $10.72 | $15.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.17 / $5.75
| Professional | | $4.17 | $4.17 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $7.08 / $17.38
| Facility | | $3.47 | $7.08 | $17.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $5.25 / $11.75
| Professional | | $2.82 | $5.25 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $34.67 / $7,079.46
| Facility | | $5.13 | $34.67 | $7,079.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $6.46 / $7.76
| Professional | | $6.46 | $6.46 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.47 / $12.30
| Professional | | $4.47 | $4.47 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $5.89 / $58.88
| Facility | | $5.50 | $5.89 | $58.88 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $6.31 / $79.43
| Facility | | $4.07 | $6.31 | $79.43 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $4.47 / $10.96
| Professional | | $2.69 | $4.47 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $4.57 / $6.76
| Professional | | $3.98 | $4.57 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.24 / $4.47 / $6.46
| Facility | | $2.24 | $4.47 | $6.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $3.72 / $12.02
| Professional | | $2.69 | $3.72 | $12.02 |