- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.46 / $18.62 / $30.20
| Facility | | $6.46 | $18.62 | $30.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $12.02
| Professional | | $3.98 | $5.01 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $33.88 / $45.71 / $5,011.87
| Facility | | $33.88 | $45.71 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $6.46
| Professional | | $5.37 | $5.37 | $6.46 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.90 / $10.47 / $23.44
| Facility | | $4.90 | $10.47 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $8.32 / $15.85
| Professional | | $3.80 | $8.32 | $15.85 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $6.92 / $10.00
| Professional | | $3.24 | $6.92 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $6.92 / $6.92
| Facility | | $6.92 | $6.92 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $7.24 / $12.02
| Professional | | $6.31 | $7.24 | $12.02 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $16.98 / $23.44
| Facility | | $5.01 | $16.98 | $23.44 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $5.01 / $7.94
| Professional | | $5.01 | $5.01 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $7.76 / $7.94
| Facility | | $4.57 | $7.76 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.57 / $6.92 / $7.94
| Professional | | $4.57 | $6.92 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $6.92 / $8.32
| Facility | | $3.80 | $6.92 | $8.32 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.02 / $4.79 / $11.22
| Professional | | $3.02 | $4.79 | $11.22 |