- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $9.12 / $22.39 / $70.79
| Facility | | $9.12 | $22.39 | $70.79 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $15.14
| Professional | | $5.01 | $6.03 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $12.02 / $38.02 / $1,445.44
| Facility | | $12.02 | $38.02 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $54.95 / $5,011.87
| Facility | | $40.74 | $54.95 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $6.03 / $7.59
| Professional | | $6.03 | $6.03 | $7.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $12.02 / $26.92
| Facility | | $5.62 | $12.02 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $10.00 / $18.62
| Professional | | $4.47 | $10.00 | $18.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $7.76 / $11.22
| Professional | | $3.63 | $7.76 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $7.76 / $7.76
| Facility | | $7.76 | $7.76 | $7.76 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $8.71 / $13.49
| Professional | | $7.59 | $8.71 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $11.48 / $25.70 / $67.61
| Facility | | $11.48 | $25.70 | $67.61 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.91 / $31.62 / $74.13
| Facility | | $8.91 | $31.62 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $11.75 / $26.30
| Facility | | $6.31 | $11.75 | $26.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.03 / $9.12
| Professional | | $5.01 | $6.03 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.76 / $9.55 / $9.55
| Facility | | $7.76 | $9.55 | $9.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $9.55 / $26.92
| Professional | | $6.76 | $9.55 | $26.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $7.76 / $9.33
| Facility | | $4.57 | $7.76 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $5.75 / $13.49
| Professional | | $3.47 | $5.75 | $13.49 |