- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $30.20 / $95.50
| Facility | | $6.46 | $30.20 | $95.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $7.94
| Professional | | $3.02 | $3.02 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $9,549.93 / $12,589.25
| Facility | | $8.32 | $9,549.93 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $22.39 / $30.20 / $5,011.87
| Facility | | $22.39 | $30.20 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $3.31 / $4.17
| Professional | | $3.31 | $3.31 | $4.17 |
- 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 / $10.00
| Professional | | $2.45 | $5.50 | $10.00 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $4.27 / $6.17
| Professional | | $2.00 | $4.27 | $6.17 |
- 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
- $7.76 / $26.30 / $97.72
| Facility | | $7.76 | $26.30 | $97.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $6,606.93 / $11,481.54
| Facility | | $8.32 | $6,606.93 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $6.61 / $15.14
| Facility | | $3.47 | $6.61 | $15.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $6.61
| Professional | | $3.02 | $3.02 | $6.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.27 / $7.08 / $7.08
| Facility | | $4.27 | $7.08 | $7.08 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $4.37 / $7.08
| Professional | | $4.07 | $4.37 | $7.08 |
- 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 / $8.13
| Professional | | $1.95 | $3.16 | $8.13 |