- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.76 / $24.55 / $91.20
| Facility | | $6.76 | $24.55 | $91.20 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $5.01 / $10.96
| Professional | | $3.98 | $5.01 | $10.96 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $5.75
| Professional | | $5.75 | $5.75 | $5.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $27.54 / $912.01
| Facility | | $8.71 | $27.54 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.90 / $40.74 / $5,011.87
| Facility | | $30.90 | $40.74 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.47 / $4.47 / $5.13
| Professional | | $4.47 | $4.47 | $5.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.17 / $8.91 / $19.95
| Facility | | $4.17 | $8.91 | $19.95 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $7.41 / $13.80
| Professional | | $3.39 | $7.41 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.69 / $5.37 / $8.32
| Professional | | $2.69 | $5.37 | $8.32 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.75 / $5.75 / $5.75
| Facility | | $5.75 | $5.75 | $5.75 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $6.46 / $10.00
| Professional | | $5.62 | $6.46 | $10.00 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.13 / $14.79 / $51.29
| Facility | | $8.13 | $14.79 | $51.29 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $3.80 / $4.90
| Professional | | $3.47 | $3.80 | $4.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $22.91 / $53.70
| Facility | | $6.61 | $22.91 | $53.70 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.07 / $8.51 / $19.50
| Facility | | $4.07 | $8.51 | $19.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $3.98 / $7.94
| Professional | | $3.98 | $3.98 | $7.94 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $218.78 / $229.09 / $316.23
| Facility | | $218.78 | $229.09 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $6.61 / $7.24
| Facility | | $5.62 | $6.61 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.62 / $6.61 / $7.24
| Professional | | $5.62 | $6.61 | $7.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.39 / $5.75 / $6.92
| Facility | | $3.39 | $5.75 | $6.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $4.17 / $9.77
| Professional | | $2.57 | $4.17 | $9.77 |