- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.94 / $23.44 / $38.02
| Facility | | $7.94 | $23.44 | $38.02 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $7.08 / $15.14
| Professional | | $5.01 | $7.08 | $15.14 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $45.71 / $60.26 / $5,011.87
| Facility | | $45.71 | $60.26 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $6.76 / $8.51
| Professional | | $6.76 | $6.76 | $8.51 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $13.18 / $28.84
| Facility | | $6.17 | $13.18 | $28.84 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $10.96 / $20.89
| Professional | | $5.13 | $10.96 | $20.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $5.13 / $12.59
| Professional | | $4.07 | $5.13 | $12.59 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $8.51 / $8.51
| Facility | | $8.51 | $8.51 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $8.32 / $9.55 / $14.79
| Professional | | $8.32 | $9.55 | $14.79 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.92 / $22.39 / $29.51
| Facility | | $6.92 | $22.39 | $29.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.08 / $10.00
| Professional | | $6.03 | $7.08 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.51 / $10.00 / $13.49
| Facility | | $8.51 | $10.00 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.59 / $10.00 / $13.49
| Professional | | $7.59 | $10.00 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $8.51 / $10.23
| Facility | | $5.01 | $8.51 | $10.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.63 / $5.62 / $14.79
| Professional | | $3.63 | $5.62 | $14.79 |