- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.61 / $19.95 / $37.15
| Facility | | $6.61 | $19.95 | $37.15 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.03 / $14.13
| Professional | | $3.98 | $6.03 | $14.13 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $27.54 / $36.31 / $5,011.87
| Facility | | $27.54 | $36.31 | $5,011.87 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $6.17 / $6.17 / $6.17
| Professional | | $6.17 | $6.17 | $6.17 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $10.72 / $26.92
| Facility | | $5.25 | $10.72 | $26.92 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $8.51 / $12.59
| Professional | | $3.16 | $8.51 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $4.57 / $11.22
| Professional | | $3.72 | $4.57 | $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
- $5.50 / $7.59 / $13.49
| Professional | | $5.50 | $7.59 | $13.49 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $13.18 / $21.88 / $46.77
| Facility | | $13.18 | $21.88 | $46.77 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $5.89
| Professional | | $4.68 | $4.68 | $5.89 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.31 / $10.96 / $22.91
| Facility | | $6.31 | $10.96 | $22.91 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.03 / $8.91
| Professional | | $3.98 | $6.03 | $8.91 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $7.76 / $12.30
| Facility | | $7.41 | $7.76 | $12.30 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $7.41 / $8.51 / $12.30
| Professional | | $7.41 | $8.51 | $12.30 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.47 / $7.76 / $9.33
| Facility | | $3.47 | $7.76 | $9.33 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $4.68 / $11.22
| Professional | | $3.31 | $4.68 | $11.22 |