- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $7.94 / $12.59
| Facility | | $4.17 | $7.94 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $3.02 / $6.31
| Professional | | $3.02 | $3.02 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.17 / $10.96
| Facility | | $4.17 | $4.17 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.04 / $2.19 / $10.00
| Professional | | $2.04 | $2.19 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $4.17 / $4.17
| Facility | | $2.51 | $4.17 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.09 / $4.17 / $4.17
| Professional | | $3.09 | $4.17 | $4.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.91 / $44.67
| Facility | | $4.07 | $8.91 | $44.67 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.82 / $6.03 / $30.20
| Professional | | $2.82 | $6.03 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $4.79 / $11.48
| Facility | | $2.51 | $4.79 | $11.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.95 / $2.95 / $8.13
| Professional | | $1.95 | $2.95 | $8.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $4.17 / $4.17
| Facility | | $4.17 | $4.17 | $4.17 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $4.17 / $5.62
| Professional | | $3.72 | $4.17 | $5.62 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $7.94 / $50,118.72
| Facility | | $5.25 | $7.94 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $5.13 / $6.92
| Facility | | $3.16 | $5.13 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1.78 / $3.24 / $9.55
| Professional | | $1.78 | $3.24 | $9.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $4.17 / $10.23
| Facility | | $3.55 | $4.17 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $4.37 / $12.59
| Professional | | $3.55 | $4.37 | $12.59 |