- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.01 / $89.13 / $933.25
| Facility | | $5.01 | $89.13 | $933.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $66.07 / $177.83
| Professional | | $4.68 | $66.07 | $177.83 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $3.63 / $3.63
| Professional | | $3.24 | $3.63 | $3.63 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.50 / $7.76 / $10.47
| Facility | | $5.50 | $7.76 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.68 / $5.25
| Professional | | $3.89 | $4.68 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $11.48 / $16.60
| Facility | | $5.37 | $11.48 | $16.60 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.24 / $5.50 / $8.13
| Professional | | $3.24 | $5.50 | $8.13 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.31 / $4.57 / $5.50
| Professional | | $3.31 | $4.57 | $5.50 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $10.47
| Facility | | $5.25 | $5.25 | $10.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $5.25 / $6.76
| Professional | | $5.25 | $5.25 | $6.76 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $9.12 / $14.45
| Facility | | $5.25 | $9.12 | $14.45 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $4.68 / $6.31
| Professional | | $4.68 | $4.68 | $6.31 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6.03 / $7.76 / $13.80
| Facility | | $6.03 | $7.76 | $13.80 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $3.89 / $4.68 / $5.25
| Professional | | $3.89 | $4.68 | $5.25 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $4.68 / $6.31 / $6.31
| Facility | | $4.68 | $6.31 | $6.31 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.19 / $3.09 / $6.61
| Professional | | $2.19 | $3.09 | $6.61 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.34 / $2.69 / $9.33
| Professional | | $2.34 | $2.69 | $9.33 |