- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $8.71 / $18.20 / $52.48
| Facility | | $8.71 | $18.20 | $52.48 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $9.77 / $30.20
| Professional | | $2.00 | $9.77 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $30.20 / $33.88 / $77.62
| Facility | | $30.20 | $33.88 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $4.79 / $6.76 / $7.24
| Professional | | $4.79 | $6.76 | $7.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.25 / $8.91 / $11.22
| Professional | | $5.25 | $8.91 | $11.22 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2.63 / $6.46 / $33.88
| Facility | | $2.63 | $6.46 | $33.88 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.00 / $2.63 / $7.94
| Professional | | $2.00 | $2.63 | $7.94 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $9.12
| Professional | | $5.37 | $5.37 | $9.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5.37 / $5.37 / $5.37
| Facility | | $5.37 | $5.37 | $5.37 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1,949.84 / $1,949.84 / $2,290.87
| Facility | | $1,949.84 | $1,949.84 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $1.86 / $2.63 / $5.89
| Facility | | $1.86 | $2.63 | $5.89 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2.51 / $2.63 / $4.79
| Professional | | $2.51 | $2.63 | $4.79 |