- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $37.15 / $63.10
| Facility | | $11.48 | $37.15 | $63.10 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $8.91 / $16.60
| Professional | | $7.94 | $8.91 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $57.54 / $75.86 / $5,011.87
| Facility | | $57.54 | $75.86 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.51 / $10.47
| Professional | | $8.51 | $8.51 | $10.47 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $16.60 / $37.15
| Facility | | $7.76 | $16.60 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $13.80 / $26.30
| Professional | | $6.31 | $13.80 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $10.72 / $15.49
| Professional | | $5.13 | $10.72 | $15.49 |
- 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
- $10.47 / $12.02 / $18.62
| Professional | | $10.47 | $12.02 | $18.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $21.88 / $33.88 / $97.72
| Facility | | $21.88 | $33.88 | $97.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $7.24 / $8.13
| Professional | | $6.46 | $7.24 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $16.60 / $31.62
| Facility | | $8.91 | $16.60 | $31.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $8.91 / $16.60
| Professional | | $7.94 | $8.91 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $10.72 / $16.60 / $16.60
| Facility | | $10.72 | $16.60 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $9.55 / $11.22 / $16.60
| Professional | | $9.55 | $11.22 | $16.60 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $10.72 / $12.88
| Facility | | $6.31 | $10.72 | $12.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $8.13 / $18.62
| Professional | | $4.90 | $8.13 | $18.62 |