- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $24.55 / $537.03
| Facility | | $5.25 | $24.55 | $537.03 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $56.23 / $173.78
| Professional | | $3.98 | $56.23 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $13.49
| Facility | | $5.25 | $5.25 | $13.49 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.57 / $2.95 / $11.75
| Professional | | $2.57 | $2.95 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.16 / $5.25 / $5.25
| Facility | | $3.16 | $5.25 | $5.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $5.25 / $5.25
| Professional | | $3.80 | $5.25 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.13 / $12.30 / $53.70
| Facility | | $5.13 | $12.30 | $53.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.55 / $7.76 / $36.31
| Professional | | $3.55 | $7.76 | $36.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $6.76 / $19.05
| Facility | | $5.01 | $6.76 | $19.05 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.45 / $3.63 / $10.23
| Professional | | $2.45 | $3.63 | $10.23 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $3.72 / $3.72
| Facility | | $3.72 | $3.72 | $3.72 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $5.01 / $6.92
| Professional | | $3.72 | $5.01 | $6.92 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.80 / $7.08 / $24.55
| Facility | | $3.80 | $7.08 | $24.55 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $9.33 / $50,118.72
| Facility | | $5.25 | $9.33 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.98 / $6.31 / $8.51
| Facility | | $3.98 | $6.31 | $8.51 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $4.07 / $11.75
| Professional | | $2.19 | $4.07 | $11.75 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $4.47 / $12.59
| Facility | | $3.72 | $4.47 | $12.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.72 / $5.25 / $19.05
| Professional | | $3.72 | $5.25 | $19.05 |